Provider Demographics
NPI:1871551291
Name:SAFIR, MICHAEL HARRIS (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HARRIS
Last Name:SAFIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N CARMELINA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-2724
Mailing Address - Country:US
Mailing Address - Phone:818-703-9500
Mailing Address - Fax:818-703-9506
Practice Address - Street 1:23101 SHERMAN PL
Practice Address - Street 2:SUITE 304
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2003
Practice Address - Country:US
Practice Address - Phone:818-703-9500
Practice Address - Fax:818-703-9506
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83654174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19742Medicare ID - Type Unspecified
CAG64337Medicare UPIN