Healthcare Provider Details

I. General information

NPI: 1558147785
Provider Name (Legal Business Name): HISHAM ALNAJJAR RVT, RDMS (AB)
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

862 LURA AVE
EL CAJON CA
92020-5820
US

IV. Provider business mailing address

862 LURA AVE
EL CAJON CA
92020-5820
US

V. Phone/Fax

Practice location:
  • Phone: 619-977-0486
  • Fax:
Mailing address:
  • Phone: 619-977-0486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XC2903X
TaxonomyVascular Specialist/Technologist Cardiovascular
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: