Popova, Yelena M.

Popova, Yelena M. is an individual health care provider with primary practice located at 3234 Marysville Blvd , Sacramento CA 95815-1411. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Popova, Yelena M. can be contacted via phone (916) 646-1200.

Contact Information

Primary practice address
3234 Marysville Blvd Sacramento CA 95815-1411
Phone: (916) 646-1200
Fax: (877) 860-2703
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X PA18255 California
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA18255 California

Profile Details

NPI number 1821061680
LBN Legal business name Popova, Yelena M.
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2006
Last updated Jun 18th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821061680 NPPES
California MEDICAID EFF: 1/31/12
California MEDICAID MACK RD-EFF 9/27/13
California Other P01453321-DV5277
California MEDICAID EFF: 2/20/13
California MEDICAID EFF: 2/20/2013
California Other P01284219/DS9933
California MEDICAID PA18255

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