Cooper, Michael J

Cooper, Michael J is an sole proprietor health care provider with primary practice located at 251 E 4Th Ave , Escondido CA 92025-4901. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cooper, Michael J can be contacted via phone (760) 745-5412.

Contact Information

Primary practice address
251 E 4Th Ave Escondido CA 92025-4901
Fax: (760) 745-2752
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 10476T California

Profile Details

NPI number 1164586244
LBN Legal business name Cooper, Michael J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 21st, 2006
Last updated Jun 26th, 2013 - about 12 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 1164586244 NPPES
California MEDICAID GSD001100

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