Provider Demographics
NPI:1770650269
Name:POPKOW, STEVEN IVAN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:IVAN
Last Name:POPKOW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12099 W WASHINGTON BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-2620
Mailing Address - Country:US
Mailing Address - Phone:310-915-8060
Mailing Address - Fax:310-915-8077
Practice Address - Street 1:12099 W WASHINGTON BLVD
Practice Address - Street 2:STE 400
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-2620
Practice Address - Country:US
Practice Address - Phone:310-915-8060
Practice Address - Fax:310-915-8077
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2017-06-19
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Provider Licenses
StateLicense IDTaxonomies
CAGO62006207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E47626Medicare UPIN