Provider Demographics
NPI:1821100116
Name:KOPELMAN, ROBERT CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHARLES
Last Name:KOPELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 OFFICE PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0612
Mailing Address - Country:US
Mailing Address - Phone:661-323-2847
Mailing Address - Fax:661-323-0566
Practice Address - Street 1:5030 OFFICE PARK DRIVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0612
Practice Address - Country:US
Practice Address - Phone:661-323-2847
Practice Address - Fax:661-323-0566
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG019228207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G192280Medicaid
CAG019228OtherMED LIC
CAG019228OtherMED LIC
A40572Medicare UPIN