Provider Demographics
NPI:1437112604
Name:SAFAEE, SAEID (MD)
Entity Type:Individual
Prefix:
First Name:SAEID
Middle Name:
Last Name:SAFAEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SAEID
Other - Middle Name:
Other - Last Name:SAFAEE-SEMIROMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1511 W GLENOAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1912
Mailing Address - Country:US
Mailing Address - Phone:818-637-2200
Mailing Address - Fax:818-637-2250
Practice Address - Street 1:1511 W GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1912
Practice Address - Country:US
Practice Address - Phone:818-637-2200
Practice Address - Fax:818-637-2250
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC-53279207RP1001X, 207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH39957Medicare UPIN