Healthcare Provider Details

I. General information

NPI: 1508770389
Provider Name (Legal Business Name): ELAHA SAHR SAFDARI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18350 HATTERAS ST APT 221
TARZANA CA
91356-1695
US

IV. Provider business mailing address

18350 HATTERAS ST APT 221 221
TARZANA CA
91356-1695
US

V. Phone/Fax

Practice location:
  • Phone: 818-424-4053
  • Fax:
Mailing address:
  • Phone: 818-424-4053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95428851
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: