Healthcare Provider Details

I. General information

NPI: 1679522288
Provider Name (Legal Business Name): DR. MATTHEW SAFAPOUR DPM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7325 MEDICAL CENTER DR STE 307
WEST HILLS CA
91307-1912
US

IV. Provider business mailing address

7325 MEDICAL CENTER DR STE 307
WEST HILLS CA
91307-1912
US

V. Phone/Fax

Practice location:
  • Phone: 818-986-9898
  • Fax: 818-986-9897
Mailing address:
  • Phone: 818-986-9898
  • Fax: 818-986-9897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4050
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW SAFAPOUR
Title or Position: OWNER
Credential: DPM
Phone: 818-986-9898