Organization Active NPI

Stephen Copen MD Inc

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1992086391
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
STEPHEN COPEN MD INC
Practice address
874 W Martin Luther King Jr Blvd
Los Angeles, CA 90037-1205
Phone
(323) 232-6161
Fax
(323) 232-1501
NPI assigned
Aug 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Authorized official

Name
Stephen T Copen, M.D.NPI 1447264981
Title
Owner
Phone
(323) 232-6131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

874 W Martin Luther King Jr Blvd
Los Angeles, CA 90037-1205

Mailing address

905 Napoli Dr
Pacific Palisades, CA 90272-4037
Phone (323) 232-6131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110923000417 CA Part B Supplier - Clinic/Group Practice 0345411369 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314662400000",
    "number": "1992086391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 NAPOLI DR",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902724037",
            "telephone_number": "323-232-6131",
            "fax_number": "323-232-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 W MARTIN LUTHER KING JR BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900371205",
            "telephone_number": "323-232-6161",
            "fax_number": "323-232-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN COPEN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-30",
        "last_updated": "2011-08-30",
        "status": "A",
        "authorized_official_last_name": "COPEN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-232-6131",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.