Provider Demographics
NPI:1750440731
Name:COPPING, RUSSELL L (DC)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:L
Last Name:COPPING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 BEACH ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2504
Mailing Address - Country:US
Mailing Address - Phone:925-685-8223
Mailing Address - Fax:925-685-5784
Practice Address - Street 1:1980 BEACH ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2504
Practice Address - Country:US
Practice Address - Phone:925-685-8223
Practice Address - Fax:925-685-5784
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC011560Medicare ID - Type UnspecifiedPROVIDER ID