Provider Demographics
NPI:1619514221
Name:ESMAEILI-FIRIDOUNI, PARDIS (DPT)
Entity Type:Individual
Prefix:DR
First Name:PARDIS
Middle Name:
Last Name:ESMAEILI-FIRIDOUNI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 14TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1309
Mailing Address - Country:US
Mailing Address - Phone:949-400-2140
Mailing Address - Fax:
Practice Address - Street 1:2000 CENTER ST STE 300
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1223
Practice Address - Country:US
Practice Address - Phone:510-644-3031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297478225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist