Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mark Anthony Cooper Jr.

Individual provider Medical Physician Assistant · NPI 1336894914

Mr. Mark Anthony Cooper Jr. is a Physician Assistant in Los Angeles, California. Qualified in 2022, 4 years ago. Practices with Domenick J Sisto M D Inc, a 10-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

1731 E 120th St
Los Angeles, CA 90059-3051
Phone: (323) 563-4800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA62888 (CA)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1336894914
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 13, 2022
Last updated in NPPESAugust 23, 2023
Certification dateAugust 23, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Domenick J Sisto M D Inc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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