Most Relevant Information
Provider Data
| NPI Number: | 1003559907 |
| Provider Name: | ELIZABETH KOPRUCKI |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/18/2022 |
| Last Updated: | 02/27/2023 |
Provider Practice Location
2075 SAN JOAQUIN HILLS RD
NEWPORT BEACH
CA
926606505
Practice Location Phone/Fax
| Phone: | 6513736604 |
| Fax: |
Provider Mailing Location
2075 SAN JOAQUIN HILLS RD
NEWPORT BEACH
CA
926606505
Provider Mailing Phone/Fax
| Phone: | 6513736604 |
| Fax: |