Healthcare Provider Details

I. General information

NPI: 1023485125
Provider Name (Legal Business Name): OSHIN SAFARIAN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 MAIN ST STE 102
BRAWLEY CA
92227-2350
US

IV. Provider business mailing address

283 MAIN ST STE 102
BRAWLEY CA
92227-2350
US

V. Phone/Fax

Practice location:
  • Phone: 760-344-3583
  • Fax: 760-344-8480
Mailing address:
  • Phone: 760-344-3583
  • Fax: 760-344-8480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number64622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: