Healthcare Provider Details

I. General information

NPI: 1659893295
Provider Name (Legal Business Name): RONAK RAHMANIAN MD, FRCSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 04/07/2023
Certification Date: 04/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 ADDISON AVE
PALO ALTO CA
94301-2401
US

IV. Provider business mailing address

1401-3315 CYPRESS PLACE
WEST VANCOUVER BRITISH COLUMBIA
V7S 3J7
CA

V. Phone/Fax

Practice location:
  • Phone: 650-327-3232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number150309
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number150309
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: