Healthcare Provider Details

I. General information

NPI: 1902224462
Provider Name (Legal Business Name): RAED EL HAJJAOUI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 TERRACINA BLVD
REDLANDS CA
92373-4850
US

IV. Provider business mailing address

350 TERRACINA BLVD
REDLANDS CA
92373-4850
US

V. Phone/Fax

Practice location:
  • Phone: 909-206-4495
  • Fax: 351-207-4611
Mailing address:
  • Phone: 909-206-4495
  • Fax: 351-207-4611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number144196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: