Provider Demographics
NPI:1851811913
Name:JAMES L COOPERMAN OD INC
Entity Type:Organization
Organization Name:JAMES L COOPERMAN OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:COOPERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-963-2111
Mailing Address - Street 1:18449 BROOKHURST ST STE 6
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6751
Mailing Address - Country:US
Mailing Address - Phone:714-963-2111
Mailing Address - Fax:714-963-4642
Practice Address - Street 1:18449 BROOKHURST ST STE 6
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6751
Practice Address - Country:US
Practice Address - Phone:714-963-2111
Practice Address - Fax:714-963-4642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty