Provider Demographics
NPI:1558348094
Name:POPA, BOGDAN RADU (MD)
Entity Type:Individual
Prefix:DR
First Name:BOGDAN
Middle Name:RADU
Last Name:POPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2045 E BERMUDA ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-2123
Mailing Address - Country:US
Mailing Address - Phone:510-290-9668
Mailing Address - Fax:714-908-7953
Practice Address - Street 1:2045 E BERMUDA ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90814-2123
Practice Address - Country:US
Practice Address - Phone:510-290-9668
Practice Address - Fax:714-908-7953
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60996207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A609960Medicaid
CAWA60996CMedicare PIN
CA00A609960Medicaid
CAWA60996BMedicare PIN