Provider Demographics
NPI:1366602138
Name:COOPER, AMY FISHMAN (MD/MPH)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:FISHMAN
Last Name:COOPER
Suffix:
Gender:F
Credentials:MD/MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27420 TOURNEY RD STE 150
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5632
Mailing Address - Country:US
Mailing Address - Phone:661-259-8999
Mailing Address - Fax:661-705-0110
Practice Address - Street 1:27420 TOURNEY RD STE 150
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5632
Practice Address - Country:US
Practice Address - Phone:661-259-8999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-14
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA065953208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics