Provider Demographics
NPI:1275564874
Name:POP, SIMONA C (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMONA
Middle Name:C
Last Name:POP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SIMONA
Other - Middle Name:C
Other - Last Name:ATTALLAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:145 THUNDER DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6010
Mailing Address - Country:US
Mailing Address - Phone:760-941-9002
Mailing Address - Fax:760-630-2515
Practice Address - Street 1:145 THUNDER DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6010
Practice Address - Country:US
Practice Address - Phone:760-941-9002
Practice Address - Fax:760-630-2515
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB221774Medicare PIN