Provider Demographics
NPI:1992736060
Name:POPOV, SASCHA M (DC)
Entity type:Individual
Prefix:DR
First Name:SASCHA
Middle Name:M
Last Name:POPOV
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16766 BERNARDO CENTER DR
Mailing Address - Street 2:STE. 101A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2545
Mailing Address - Country:US
Mailing Address - Phone:858-485-7505
Mailing Address - Fax:858-485-0852
Practice Address - Street 1:16766 BERNARDO CENTER DR
Practice Address - Street 2:STE. 101A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2545
Practice Address - Country:US
Practice Address - Phone:858-485-7505
Practice Address - Fax:858-485-0852
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor