Provider Demographics
NPI:1306956362
Name:FALSAFI, SASSAN (MD)
Entity type:Individual
Prefix:DR
First Name:SASSAN
Middle Name:
Last Name:FALSAFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 MORAGA RD
Mailing Address - Street 2:STE 102
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4591
Mailing Address - Country:US
Mailing Address - Phone:925-299-9919
Mailing Address - Fax:925-299-9924
Practice Address - Street 1:911 MORAGA RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4579
Practice Address - Country:US
Practice Address - Phone:925-299-9919
Practice Address - Fax:510-635-9514
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85934207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A859340Medicare ID - Type Unspecified
CAI11586Medicare UPIN