Provider Demographics
NPI:1932490919
Name:JAHANIAN, ARDESHIR (MD)
Entity Type:Individual
Prefix:
First Name:ARDESHIR
Middle Name:
Last Name:JAHANIAN
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 1:10978 BIG CANOE
Mailing Address - Street 2:
Mailing Address - City:BIG CANOE
Mailing Address - State:GA
Mailing Address - Zip Code:30143-5140
Mailing Address - Country:US
Mailing Address - Phone:408-888-8960
Mailing Address - Fax:
Practice Address - Street 1:3083 E RUBY HILL DR
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-2138
Practice Address - Country:US
Practice Address - Phone:408-888-8960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123469207L00000X
GA91627207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology