Provider Demographics
NPI:1265518054
Name:POPEL, OLGA NEONILA (MD)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:NEONILA
Last Name:POPEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1250 LA VENTA DR STE 211
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-3764
Practice Address - Country:US
Practice Address - Phone:805-494-6920
Practice Address - Fax:805-494-6922
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42577207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A49027Medicare UPIN
CAG42577Medicare ID - Type Unspecified
CAG42577AMedicare ID - Type Unspecified
G42577AMedicare Oscar/Certification
G42577Medicare PIN