Provider Demographics
NPI:1275006686
Name:SEKIYOBA, SAFARI MARTIN (DNP, FNP-BC, NP-C)
Entity Type:Individual
Prefix:DR
First Name:SAFARI
Middle Name:MARTIN
Last Name:SEKIYOBA
Suffix:
Gender:M
Credentials:DNP, FNP-BC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-1728
Mailing Address - Country:US
Mailing Address - Phone:323-594-9398
Mailing Address - Fax:
Practice Address - Street 1:2829 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-3304
Practice Address - Country:US
Practice Address - Phone:213-699-7114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily