Provider Demographics
NPI:1518557628
Name:GAJIANI, RABKA AISHA
Entity Type:Individual
Prefix:
First Name:RABKA
Middle Name:AISHA
Last Name:GAJIANI
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 1:101 BLUE NOTE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1308
Mailing Address - Country:US
Mailing Address - Phone:949-274-2581
Mailing Address - Fax:
Practice Address - Street 1:7626 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-8529
Practice Address - Country:US
Practice Address - Phone:714-288-8744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist