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NPI Code Detail

MEDICARE: SULA M SAFAR DO

MEDICARE: SULA M SAFAR DO
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 Physician20A11180CA

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 : 1225294713
Entity Type Code : Individual
Provider Name (Legal Business Name) : SULA M SAFAR DO
Provider Business Mailing Address
First Line : 3110 CHINO AVE STE 150A
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-1295
Country : US
Telephone Number : 909-630-7490
Fax Number : 909-469-2108
Provider Business Practice Location Address
First Line : 3110 CHINO AVE STE 150A
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-1295
Country : US
Telephone Number : 909-630-7490
Fax Number : 909-630-7491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2008
Last Update Date : 03/07/2023

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Directions to “ SULA M SAFAR DO” Practice Location

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