Healthcare Provider Details

I. General information

NPI: 1235394875
Provider Name (Legal Business Name): ROKNEDIN SAFAVI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3255 ESPLANADE
CHICO CA
95973-0255
US

IV. Provider business mailing address

3255 ESPLANADE
CHICO CA
95973-0255
US

V. Phone/Fax

Practice location:
  • Phone: 530-899-3150
  • Fax: 530-899-3160
Mailing address:
  • Phone: 530-899-3150
  • Fax: 530-899-3160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35045246
License Number StateOH

VIII. Authorized Official

Name: DR. ROKNEDIN SAFAVI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 530-899-3150