Healthcare Provider Details

I. General information

NPI: 1679406466
Provider Name (Legal Business Name): PARDIS ESMAEILI-FIRIDOUNI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3527 GRAND AVE STE C
OAKLAND CA
94610-2045
US

IV. Provider business mailing address

2908 ACTON ST
BERKELEY CA
94702-2516
US

V. Phone/Fax

Practice location:
  • Phone: 415-493-8636
  • Fax:
Mailing address:
  • Phone: 415-493-8636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: PARDIS ESMAEILI-FIRIDOUNI
Title or Position: OWNER
Credential: DPT
Phone: 415-493-8636