Provider Demographics
NPI:1902402407
Name:SAFIYA, MARYAM NOURI (DACM)
Entity type:Individual
Prefix:DR
First Name:MARYAM
Middle Name:NOURI
Last Name:SAFIYA
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1516 WESTWOOD BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5616
Mailing Address - Country:US
Mailing Address - Phone:424-777-5380
Mailing Address - Fax:424-777-4090
Practice Address - Street 1:1516 WESTWOOD BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5616
Practice Address - Country:US
Practice Address - Phone:424-777-5380
Practice Address - Fax:424-777-4090
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18881171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist