Healthcare Provider Details

I. General information

NPI: 1902023989
Provider Name (Legal Business Name): NAHID NIKKI ESANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S BUENA VISTA ST
BURBANK CA
91505-4809
US

IV. Provider business mailing address

PO BOX 3975
GLENDALE CA
91221-0975
US

V. Phone/Fax

Practice location:
  • Phone: 818-847-6332
  • Fax:
Mailing address:
  • Phone: 818-559-5610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License NumberA74583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: