1588748362 NPI number — SAHAR W TAWFIK DDS INC

Table of content: (NPI 1588748362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588748362 NPI number — SAHAR W TAWFIK DDS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAHAR W TAWFIK DDS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588748362
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 VAN NESS AVENUE
Provider Second Line Business Mailing Address:
SUITE 2020
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-441-4933
Provider Business Mailing Address Fax Number:
415-441-4933

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 VAN NESS AVENUE
Provider Second Line Business Practice Location Address:
SUITE 2020
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-441-4933
Provider Business Practice Location Address Fax Number:
415-441-4933
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAWFIK
Authorized Official First Name:
SAHAR
Authorized Official Middle Name:
W
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
650-917-9603

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  42502 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: 42502 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000042502 . This is a "DELTA DENTAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 0005934416 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 011888 . This is a "DELTA CARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: DA0254360 . This is a "BLUE SHIELD OF CALIFORNIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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