Schraudenbach, Cooper C

Schraudenbach, Cooper C is an individual health care provider with primary practice located at 1 Clinic Rd , Grand Canyon AZ 86023-0290. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Schraudenbach, Cooper C can be contacted via phone (928) 638-2551.

Contact Information

Primary practice address
1 Clinic Rd Grand Canyon AZ 86023-0290
Phone: (928) 638-2551
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0348 Northern Mariana Islands
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A067909 California
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 45923 Arizona

Profile Details

NPI number 1790848299
LBN Legal business name Schraudenbach, Cooper C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2006
Last updated Mar 22nd, 2021 - about 3 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 1790848299 NPPES
California Other A67909 LICENSE
California Other 0348 LICENSE
California Other 12456 LICENSE

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