Healthcare Provider Details
I. General information
NPI: 1932828589
Provider Name (Legal Business Name): ALWAHAB MD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2022
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3835 AVOCADO BLVD STE 150
LA MESA CA
91941-8524
US
IV. Provider business mailing address
250 E CHASE AVE STE 110
EL CAJON CA
92020-6305
US
V. Phone/Fax
- Phone: 619-499-5006
- Fax:
- Phone: 619-499-5006
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AREEJ
ALWAHAB
Title or Position: OWNER/PROVIDER
Credential: MD
Phone: 858-717-1757