Provider Demographics
NPI:1487872172
Name:SAFAI, MASSY (MD)
Entity type:Individual
Prefix:DR
First Name:MASSY
Middle Name:
Last Name:SAFAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 HILLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PORTOLA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94028-7933
Mailing Address - Country:US
Mailing Address - Phone:650-248-6699
Mailing Address - Fax:
Practice Address - Street 1:75 HILLBROOK DR
Practice Address - Street 2:
Practice Address - City:PORTOLA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94028-7933
Practice Address - Country:US
Practice Address - Phone:650-248-6699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA053640174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist