Active NPI
Alexander Popov
- General Practice Physician
- North Hollywood, CA
National Provider Identifier
1184652760
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Aug 20, 2012.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A78244
- Practice address
- 12512 Victory Blvd
#D
North Hollywood, CA 91606-3180 - Phone
- (818) 753-9994
- Fax
- (818) 753-8621
- NPI assigned
- Jun 30, 2006
- Last updated
- Jul 10, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A78244 | CA | Primary |
Addresses
Primary practice location
12512 Victory Blvd
#D
North Hollywood, CA 91606-3180
Mailing address
12512 Victory Blvd
#D
North Hollywood, CA 91606-3180
Phone (818) 753-9994
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A78244 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247184000000",
"number": "1184652760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12512 VICTORY BLVD",
"address_2": "#D",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916063180",
"telephone_number": "818-753-9994",
"fax_number": "818-753-8621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12512 VICTORY BLVD",
"address_2": "#D",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916063180",
"telephone_number": "818-753-9994",
"fax_number": "818-753-8621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPOV",
"first_name": "ALEXANDER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2009-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "A78244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.