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General NPI Number Information
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NPI Number | 1275006686
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Entity Type | Individual
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Provider Name | SAFARI MARTIN SEKIYOBA DNP, FNP-BC, NP-C
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Gender | Male
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 2829 S GRAND AVE
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City | LOS ANGELES
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State | CA
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Zip | 90007-3304
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Country | US
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Telephone | 213-699-7114
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Fax |
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Provider Business Mailing Address
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Address Line | 3840 WEST BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90008-1728
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Country | US
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Telephone | 323-594-9398
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95010756
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License Number State | CA
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