Provider Demographics
NPI:1255561726
Name:POPA-RADU, MATEI (DO)
Entity type:Individual
Prefix:
First Name:MATEI
Middle Name:
Last Name:POPA-RADU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4646 BROCKTON AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-0103
Mailing Address - Country:US
Mailing Address - Phone:951-682-6900
Mailing Address - Fax:951-682-6905
Practice Address - Street 1:4646 BROCKTON AVE STE 301
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-0103
Practice Address - Country:US
Practice Address - Phone:951-682-6900
Practice Address - Fax:951-682-6905
Is Sole Proprietor?:No
Enumeration Date:2009-07-19
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A16191207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A16191OtherOSTEOPATHIC MEDICAL BOARD OF CALIFORNIA