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General NPI Number Information
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NPI Number | 1467952036
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Entity Type | Individual
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Provider Name | MIKAELA K POPE PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 2350 BUHNE ST
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City | EUREKA
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State | CA
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Zip | 95501-3238
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Country | US
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Telephone | 440-324-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 15910 FERNWAY RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-3358
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Country | US
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Telephone | 216-456-7432
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA62764
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.005471RX
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License Number State | OH
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