Provider Demographics
NPI:1093833980
Name:SAFA, BAUBACK
Entity Type:Individual
Prefix:DR
First Name:BAUBACK
Middle Name:
Last Name:SAFA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CASTRO ST
Mailing Address - Street 2:SUITE,121
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1010
Mailing Address - Country:US
Mailing Address - Phone:415-565-6136
Mailing Address - Fax:415-864-1654
Practice Address - Street 1:45 CASTRO ST
Practice Address - Street 2:SUITE 121
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1010
Practice Address - Country:US
Practice Address - Phone:415-565-6136
Practice Address - Fax:415-864-1654
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83763208200000X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA83763OtherMEDICAL LICENSE
CABS8361329OtherDEA