Provider Demographics
NPI:1245277664
Name:COPPA, LILIA FERNANDEZ (MD)
Entity type:Individual
Prefix:DR
First Name:LILIA
Middle Name:FERNANDEZ
Last Name:COPPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LILIA
Other - Middle Name:
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:24422 AVENIDA DE LA CARLOTA STE 300
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3628
Mailing Address - Country:US
Mailing Address - Phone:949-599-2423
Mailing Address - Fax:949-599-2430
Practice Address - Street 1:451 W GONZALES RD STE 130
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0721
Practice Address - Country:US
Practice Address - Phone:805-981-7691
Practice Address - Fax:805-981-7676
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG077445208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG25578Medicare UPIN