Basic Information
| Provider Information | |||||||||
| NPI: | 1437418332 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SAFAVY | ||||||||
| FirstName: | SEENA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3495 PIEDMONT RD NE | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303051717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043650966 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4900 W SUNSET BLVD FL 2 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900275814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3237835853 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2012 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | A127441 | CA | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | 080638 | GA | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.