Healthcare Provider Details

I. General information

NPI: 1174681332
Provider Name (Legal Business Name): SAIF KABIR M. S. , CCC- A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17050 CHATSWORTH ST STE 103
GRANADA HILLS CA
91344-5967
US

IV. Provider business mailing address

17050 CHATSWORTH ST STE 103
GRANADA HILLS CA
91344-5967
US

V. Phone/Fax

Practice location:
  • Phone: 818-488-9303
  • Fax:
Mailing address:
  • Phone: 818-488-9303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU 2065
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: