Charles Steven Koopman, PHARM D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

5928902-1701 Issued in UT

Practice address

11201 Benton St
Loma Linda, CA 92357-1500

Phone

(909) 825-7084

Fax

(909) 422-3017

NPI assigned

May 3, 2007

Last updated

Jul 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Paul Ream Enterprises

  dba Reams Family Foods

  • Pharmacy
  • Provo, UT
  • NPI 1679546709
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1154543890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6624 VENETO PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917019018",
            "telephone_number": "909-219-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923571500",
            "telephone_number": "909-825-7084",
            "fax_number": "909-422-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOPMAN",
        "first_name": "CHARLES",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "68391",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "5928902-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saahithi Priya Kolli
• Samyuta Komaravolu, MD
• Soujanya Kondameedi
• Ling Fung Kong
• Ja Eun Koo
• Brandon Barry Koperski, M.D.
• Sridevi Kesavan Korand
• Marisela Koreerat
• Patricia Mary Korszyk, PA-C
• Juthamas Kositsawat

• Pharmacist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.