Individual
SORENA KEIHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MSCI
Contact information
Practice address
520 S EAGLE RD STE 3112, MERIDIAN, ID 83642-6352
(208) 706-5800
(208) 706-5810
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
12400317-1205
UT
208800000X
Urology Physician
Primary
1271357
ID
208800000X
Urology Physician
DR.0075039
CO
Other
Enumeration date
02/06/2020
Last updated
07/16/2025
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