Provider Demographics
NPI:1710783774
Name:SAFIQ, MOHAMMED SHAMEEL (RD CSCS)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:SHAMEEL
Last Name:SAFIQ
Suffix:
Gender:M
Credentials:RD CSCS
Other - Prefix:
Other - First Name:SHAMEEL
Other - Middle Name:
Other - Last Name:SAFIQ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD CSCS
Mailing Address - Street 1:829 S LE DOUX RD APT 4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1852
Mailing Address - Country:US
Mailing Address - Phone:510-754-7597
Mailing Address - Fax:
Practice Address - Street 1:829 S LE DOUX RD APT 4
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1852
Practice Address - Country:US
Practice Address - Phone:510-754-7597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered