Cooper, Gary Harry

Cooper, Gary Harry is an individual health care provider with primary practice located at 2175 South Ave , South Lake Tahoe CA 96150-7024. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Cooper, Gary Harry can be contacted via phone (530) 543-5685.

Contact Information

Primary practice address
2175 South Ave South Lake Tahoe CA 96150-7024
Phone: (530) 543-5685
Fax: (530) 544-2503
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G19546 California
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X G19546 California

Profile Details

NPI number 1487653663
LBN Legal business name Cooper, Gary Harry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Sep 20th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487653663 NPPES
California Other P00213444 MEDICARE RR

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