Provider Demographics
NPI:1922299031
Name:MICHAEL H SAFIR M D A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MICHAEL H SAFIR M D A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-703-9500
Mailing Address - Street 1:23101 SHERMAN PL
Mailing Address - Street 2:# 304
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2003
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:# 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19742Medicare PIN