Healthcare Provider Details

I. General information

NPI: 1497138002
Provider Name (Legal Business Name): AREEJ ALWAHAB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E CHASE AVE STE 110
EL CAJON CA
92020-6305
US

IV. Provider business mailing address

250 E CHASE AVE STE 110
EL CAJON CA
92020-6305
US

V. Phone/Fax

Practice location:
  • Phone: 619-399-7878
  • Fax: 855-499-5006
Mailing address:
  • Phone: 619-399-7878
  • Fax: 855-499-5006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301501066
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA166758
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: