Provider Demographics
NPI:1639780075
Name:COOPER, ANNINA (MS, GC)
Entity Type:Individual
Prefix:
First Name:ANNINA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:MS, GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4359 CHARLEMAGNE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1410
Mailing Address - Country:US
Mailing Address - Phone:562-900-5232
Mailing Address - Fax:
Practice Address - Street 1:4580 ELECTRONICS PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1008
Practice Address - Country:US
Practice Address - Phone:562-900-5232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS