Healthcare Provider Details

I. General information

NPI: 1073437281
Provider Name (Legal Business Name): DR. MAHSA SAFAVI M.D. MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30230 RANCHO VIEJO RD STE 200
SAN JUAN CAPISTRANO CA
92675-1585
US

IV. Provider business mailing address

PO BOX 7363
LAGUNA NIGUEL CA
92607-7363
US

V. Phone/Fax

Practice location:
  • Phone: 949-443-4303
  • Fax:
Mailing address:
  • Phone: 949-378-1022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAHSA SAFAVI
Title or Position: PHYSICIAN
Credential:
Phone: 949-378-1022