Provider Demographics
NPI:1659472058
Name:HAJIANI, RAFIEH (MD)
Entity Type:Individual
Prefix:
First Name:RAFIEH
Middle Name:
Last Name:HAJIANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0302
Practice Address - Country:US
Practice Address - Phone:916-536-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81116208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7829506OtherAETNA
CA90134899OtherPACIFICARE
CA100973OtherHEALTH NET
CA1663594OtherGREAT WEST
CAMCMG257400OtherWESTERN HEALTH ADVANTAGE
CA9010366OtherCIGNA
CA00A811160Medicaid
CA2130932OtherFIRST HEALTH
CA2315397OtherUNITED HEALTHCARE
CA00A811160OtherBLUE SHIELD
CAA81116OtherBLUE CROSS
CA98233OtherINTERPLAN
CA7829506OtherAETNA
H84114Medicare UPIN