MRS. TAYLER SUZANNE KOPPERUD (NPI# 1548811037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548811037 |
| Entity Type | Individual |
| Full Name | MRS. TAYLER SUZANNE KOPPERUD |
| Credential | RCS, RVS |
| Practice Address |
4959 Palo Verde St Ste 208c-4 Montclair CA 91763-2360 |
| Practice Telephone | 9096757362 |
| Mailing Telephone | 9096757362 |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2020-05-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246XC2903X |
Spec/Tech, Cardiovascular Specialization: Vascular Specialist |
00868169 | CA | Technologists, Technicians & Other Technical Service Providers |
| Y | 246XS1301X |
Spec/Tech, Cardiovascular Specialization: Sonography |
00868169 | CA | Technologists, Technicians & Other Technical Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1816 E Olive St, Ontario, CA 917641211 | 9092314460 |
| Street Address |
4959 PALO VERDE ST STE 208C-4 |
| City | MONTCLAIR |
| State | CA |
| Zip Code | 91763-2360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730707811 | Kopper Imaging | Clinic/Center | 4959 Palo Verde St Ste 208c-4, Montclair, CA 91763-2360 | 2020-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335760 | Cho Jeon Yun Dental Partnership | Dentist | 9655 Monte Vista Ave #406, Montclair, CA 91763 | 2020-08-07 |
| 1215498811 | Above Urgent Care Center | Emergency Medicine | 8891 N. Central Ave Ste A, Montclair, CA 91763 | 2019-03-27 |
| 1467936906 | Bronislava Kroulik | Behavior Technician | 4950 San Bernardino St Ste 101, Montclair, CA 91763 | 2018-09-20 |
| 1063936110 | Monique Karina Enriquez | Licensed Vocational Nurse | 5580 Moreno St #82, Montclair, CA 91763 | 2017-07-31 |
| 1972961159 | Lacy Pinsky | Specialist/Technologist | 5035 Flora St., Montclair, CA 91763 | 2016-02-03 |
| 1912333790 | Cinta Hospice Care Inc | Hospice Care, Community Based | 5050 Palo Verde Street, Suite 101, Montclair, CA 91763 | 2013-09-24 |
| 1720334626 | Priority One Hospice, Inc. | Hospice Care, Community Based | 4959 Palo Verde St Ste 107c, Montclair, CA 91763 | 2012-07-28 |
| 1689982498 | Paulina Trujillo Perez | Counselor | 9916 Central Ave., Montclair, CA 91763 | 2010-09-15 |
| 1982846499 | Esther Phillips Agepogu | Physician Assistant | 9301 Central Ave., Montclair, CA 91763 | 2009-03-30 |
| 1568633139 | Mahin Nosrati-jahromi | Dentist | 9509 Central Ave #d, Montclair, CA 91763 | 2008-03-21 |
| Find all providers in zip 91763 | ||||
| Taxonomy Code | 246XS1301X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Cardiovascular |
| Specialization | Sonography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548895824 | Mahsa Hatamifar | Spec/Tech, Cardiovascular | 5810 Van Nuys Blvd, Van Nuys, CA 91401-4218 | 2020-03-07 |
| 1477198125 | Gregory Barsom | Spec/Tech, Cardiovascular | 4740 Los Feliz Blvd, Los Angeles, CA 90027-1918 | 2019-11-15 |
| 1215587704 | Mehrnoush Raissi Ardali | Spec/Tech, Cardiovascular | 7811 Talbert Ave Apt 19, Huntington Beach, CA 92648-1387 | 2019-09-16 |
| 1497269369 | Md Ultrasound, Inc. | Spec/Tech, Cardiovascular | 356 E Olive Ave Ste 102, Burbank, CA 91502-1228 | 2017-11-29 |
| 1265942957 | Arthur Lindberg Murray | Spec/Tech, Cardiovascular | 150 Rankin Way, Benicia, CA 94510-2109 | 2017-10-06 |
| 1578919296 | Mona Oyos | Spec/Tech, Cardiovascular | 216 Mount Hermon Rd # 346e, Scotts Valley, CA 95066-4030 | 2016-05-12 |
| 1215316740 | Medultrasound | Spec/Tech, Cardiovascular | 5310 Zelzah Ave, #105, Encino, CA 91316-2212 | 2015-05-29 |
| 1821483603 | Jonathan Schnack | Spec/Tech, Cardiovascular | 1776 Old Middlefield Way Uppr Health, Mountain View, CA 94043-1809 | 2015-03-30 |
| 1144649880 | Skilltech Dx Inc | Spec/Tech, Cardiovascular | 8500 Val Verde Dr, West Hills, CA 91304-2135 | 2014-04-09 |
| 1750706149 | Tasneem Akhtar Sr. | Spec/Tech, Cardiovascular | 2305 Monroe St Apt 12, Santa Clara, CA 95050-3336 | 2014-02-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MRS. TAYLER SUZANNE KOPPERUD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.