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NPI Code Detail

MEDICARE: SHAVASH SAFVATI M D INC

MEDICARE: SHAVASH SAFVATI M D INC
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
1207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144536228
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHAVASH SAFVATI M D INC
Provider Business Mailing Address
First Line : 12626 RIVERSIDE DR
Second Line : SUITE #303
City : NORTH HOLLYWOOD
State : CA
Zip : 91607-3420
Country : US
Telephone Number : 818-760-2434
Fax Number : 818-760-8832
Provider Business Practice Location Address
First Line : 12626 RIVERSIDE DR
Second Line : SUITE #303
City : NORTH HOLLYWOOD
State : CA
Zip : 91607-3420
Country : US
Telephone Number : 818-760-2434
Fax Number : 818-760-8832
Authorized Official
Title or Position : PRESIDENT
Name : DR. SHAVASH SAFVATI
Credential : MD
Telephone Number : 818-760-2434
Provider Enumeration Date : 08/26/2010
Last Update Date : 06/26/2023

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Directions to “SHAVASH SAFVATI M D INC ” Practice Location

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