Provider Demographics
NPI:1528946431
Name:RAHIMIAN KORDESTANI, KANI
Entity type:Individual
Prefix:
First Name:KANI
Middle Name:
Last Name:RAHIMIAN KORDESTANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E DANA ST APT 60
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94041-2436
Mailing Address - Country:US
Mailing Address - Phone:404-644-9594
Mailing Address - Fax:
Practice Address - Street 1:459 POWELL ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1503
Practice Address - Country:US
Practice Address - Phone:415-984-0793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist