Matthew Dale Cooper (NPI# 1528353190, PAC ID# 1951693381) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1528353190 |
| PAC ID by PECOS | 1951693381 |
| Professional Enrollment ID | I20160706000277 |
| Full Name | Matthew Dale Cooper |
| Organization Legal Name | OLDE DEL MAR SURGICAL MEDICAL GROUP INC |
| Address |
9850 Genesee Ave Suite 570 La Jolla CA 92037-1229 |
| Phone Number | 8584574917 |
| Gender | M |
| Medical School | UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE |
| Graduation Year | 2007 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 6800957374 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050324 | SCRIPPS MEMORIAL HOSPITAL LA JOLLA |
| 030006 | TUCSON MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 9850 Genesee Ave, Suite 570, La Jolla, CA 92037-1229 | 8584574917 | OLDE DEL MAR SURGICAL MEDICAL GROUP INC |
| Organization Legal Name | OLDE DEL MAR SURGICAL MEDICAL GROUP INC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sunil Bhoyrul | General Surgery | Olde Del Mar Surgical Medical Group Inc | 9850 Genesee Ave, Suite 570, La Jolla, CA 92037-1229 |
| Kirsten S Goshen | Nurse Practitioner | Olde Del Mar Surgical Medical Group Inc | 9850 Genesee Ave, Suite 570, La Jolla, CA 92037-1229 |
| Street Address |
9850 GENESEE AVE SUITE 570 |
| City | LA JOLLA |
| State | CA |
| Zip | 92037-1229 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Heinz J Lenz | Gastroenterology | La Jolla Gastroenterology Medical Group, Inc | 9850 Genesee Ave, Suite 820, La Jolla, CA 92037-1219 |
| Mark C Adrian | Internal Medicine | 9850 Genesee Ave, Suite 355, La Jolla, CA 92037-1227 | |
| Mahmood Mahdavi | Otolaryngology | 9850 Genesee Ave, Suite 710, La Jolla, CA 92037-1218 | |
| Cheryl L Olson | General Surgery | Surgical Associates of La Jolla Medical Group, Inc. | 9850 Genesee Ave, Suite 660, La Jolla, CA 92037-1231 |
| William C Mohlenbrock | Orthopedic Surgery | Torrey Pines Orthopaedic Medical Group Inc | 9850 Genesee Ave, Suite 210, La Jolla, CA 92037-1206 |
| Mohamed Omar Radwan | Pulmonary Disease | La Jolla Pulmonary and Critical Care Inc | 9850 Genesee Ave, Suite 780, La Jolla, CA 92037-1232 |
| Cortney Wilcox | Nurse Practitioner | Monica Perlman Md Inc | 9850 Genesee Ave, Suite 320, La Jolla, CA 92037-1208 |
| Seymour Myers | Family Medicine | Monica Perlman Md Inc | 9850 Genesee Ave, Suite 320, La Jolla, CA 92037-1208 |
| Stephen Caso | Physician Assistant | Monica Perlman Md Inc | 9850 Genesee Ave, Suite 320, La Jolla, CA 92037-1208 |
| Edward Cohen | Urology | Genesis Healthcare Partners PC | 9850 Genesee Ave, Suite 440, La Jolla, CA 92037-1212 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marjan Davoudi | Psychologist, Clinical | 3262 Holiday Court, Suite 220, La Jolla, CA 92037 | |
| Vanessa R Wang | Physician Assistant | Scripps Health | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 |
| Robert R Varney | Interventional Radiology | Scripps Health | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 |
| Gordon Lee Kim | Gastroenterology | Scripps Health | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 |
| Peter D Aldrich | Internal Medicine | Scripps Health | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 |
| Katrina I Deleon | Geriatric Medicine | Scripps Health | 10666 N Torrey Pines Rd, 2nd Floor Sw209, La Jolla, CA 92037-1027 |
| Virginia T Chan | Hospitalist | Scripps Health | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 |
| Laura J Nicholson | Hospitalist | Scripps Health | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 |
| Christopher L Marsh | Urology | Scripps Health | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 |
| Shazia M Jamil | Critical Care (intensivists) | Scripps Health | 10666 N Torrey Pines Rd, 2nd Floor Sw209, La Jolla, CA 92037-1027 |
| Find all physicians in zip 92037 | |||
| City | LA JOLLA |
| Zip Code | 92037 |
| Specialty | GENERAL SURGERY |
| City + Specialty | LA JOLLA + GENERAL SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.