Healthcare Provider Details

I. General information

NPI: 1386373298
Provider Name (Legal Business Name): DR. YOUNES SAFA INC, APDC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

960 EAST GREEN STREET SUITE 11
PASADENA CA
91106
US

IV. Provider business mailing address

960 EAST GREEN STREET SUITE 11
PASADENA CA
91106
US

V. Phone/Fax

Practice location:
  • Phone: 626-304-3636
  • Fax: 626-304-3634
Mailing address:
  • Phone: 626-304-3636
  • Fax: 626-304-3634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: YOUNES SAFA
Title or Position: OWNER
Credential: DDS
Phone: 626-304-3636