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NPI Code Detail

MEDICARE: DR. DORA T AKUETTEH-SAFORO M.D, FAAFP

MEDICARE:  DR. DORA T AKUETTEH-SAFORO  M.D, FAAFP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA061329CA

General Provider Information

NPI Number : 1083616783
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DORA T AKUETTEH-SAFORO M.D, FAAFP
Provider Business Mailing Address
First Line : 310514 STUART MESA RD
Second Line : CAMP PENDLETON
City : OCEANSIDE
State : CA
Zip : 92055-5191
Country : US
Telephone Number : 760-725-7499
Fax Number :
Provider Business Practice Location Address
First Line : 200 MERCY CIRCLE
Second Line : NAVAL HOSPITAL CAMP PENDLETON
City : OCEANSIDE
State : CA
Zip : 92055-5191
Country : US
Telephone Number : 760-725-7499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 02/04/2025

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