Popovich, Mark J

Popovich, Mark J is an individual health care provider with primary practice located at 3883 Airway Dr Ste 100 , Santa Rosa CA 95403-1672. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Popovich, Mark J can be contacted via phone (707) 521-4480.

Contact Information

Primary practice address
3883 Airway Dr Ste 100 Santa Rosa CA 95403-1672
Phone: (707) 521-4480
Fax: (707) 521-4460
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X G57995 California
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X G57995 California
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound 2085U0001X G57995 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G57995 California

Profile Details

NPI number 1245320704
LBN Legal business name Popovich, Mark J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Aug 26th, 2019 - about 7 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 1245320704 NPPES
California MEDICAID 00G579950
California Other 473423
California Other G57995

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