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General NPI Number Information
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NPI Number | 1447655188
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Entity Type | Organization
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Legal Business Name | MOHSEN SAFAIE PT INC.
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 11650 RIVERSIDE DR 2ND FLOOR
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91602-1093
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Country | US
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Telephone | 818-755-6070
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Fax |
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Provider Business Mailing Address
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Address Line | 4843 ALMIDOR AVE
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-3708
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Country | US
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Telephone | 818-389-6660
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHSEN SAFAIE
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Credential | RPT
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Telephone | 818-389-6660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT13563
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License Number State | CA
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