Provider Demographics
NPI:1013384882
Name:COOPER, ABBY (LAC DIPL OM)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:LAC DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2846 EL DORADO ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6038
Mailing Address - Country:US
Mailing Address - Phone:760-586-0459
Mailing Address - Fax:
Practice Address - Street 1:2424 TORRANCE BLVD STE B
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-2453
Practice Address - Country:US
Practice Address - Phone:760-586-0459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00001985171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist