MEDICARE: DR. BOGDAN RADU POPA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	A60996	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558348094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BOGDAN RADU POPA M.D.

Provider Business Mailing Address
First Line	:	2045 E BERMUDA ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90814-2123
Country	:	US
Telephone Number	:	510-290-9668
Fax Number	:	714-908-7953

Provider Business Practice Location Address
First Line	:	2045 E BERMUDA ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90814-2123
Country	:	US
Telephone Number	:	510-290-9668
Fax Number	:	714-908-7953

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	11/09/2007

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