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General NPI Number Information
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NPI Number | 1285823914
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Entity Type | Organization
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Legal Business Name | STELLAR HEALTH MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 09/07/2013
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Provider Practice Location Address
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Address Line | 7258 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90046-3410
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Country | US
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Telephone | 323-654-7716
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Fax | 323-654-7771
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Provider Business Mailing Address
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Address Line | 7258 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90046-3410
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Country | US
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Telephone | 323-654-7716
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Fax | 323-654-7771
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Authorized Official
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Title or Position | DIRECTOR/PRESIDENT
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Name | DR. STELLA POPOVA
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Credential | M.D.
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Telephone | 323-654-7716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A65599
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License Number State | CA
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