Provider Demographics
NPI:1174652739
Name:POPE, DAVID JOHN (PHD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOHN
Last Name:POPE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 SANTA MONICA BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-5970
Mailing Address - Country:US
Mailing Address - Phone:310-962-6725
Mailing Address - Fax:310-734-7841
Practice Address - Street 1:8060 MELROSE AVE STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-7037
Practice Address - Country:US
Practice Address - Phone:310-962-6725
Practice Address - Fax:310-734-7841
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 14364103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP14364BMedicare ID - Type Unspecified