Provider Demographics
NPI:1316996135
Name:SAFAPOUR, MATTHEW M (DPM)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:M
Last Name:SAFAPOUR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7325 MEDICAL CENTER DR STE 307
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1912
Mailing Address - Country:US
Mailing Address - Phone:818-986-9898
Mailing Address - Fax:818-986-9897
Practice Address - Street 1:7325 MEDICAL CENTER DR STE 307
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1912
Practice Address - Country:US
Practice Address - Phone:818-986-9898
Practice Address - Fax:818-986-9897
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4050213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E40502Medicaid
CAU66351Medicare UPIN
CA000E40502Medicaid