Provider Demographics
NPI:1285814509
Name:BOPPANA, SWAPNA (MD)
Entity Type:Individual
Prefix:
First Name:SWAPNA
Middle Name:
Last Name:BOPPANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11480 BROOKSHIRE AVE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5018
Mailing Address - Country:US
Mailing Address - Phone:562-869-1201
Mailing Address - Fax:
Practice Address - Street 1:11480 BROOKSHIRE AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5018
Practice Address - Country:US
Practice Address - Phone:562-869-1201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.014123207R00000X
CAA127873207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine