Healthcare Provider Details

I. General information

NPI: 1235350893
Provider Name (Legal Business Name): MOHAMMAD ANAS HAJJAR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N TUSTIN AVE STE 205
SANTA ANA CA
92705-6506
US

IV. Provider business mailing address

999 N TUSTIN AVE STE 205
SANTA ANA CA
92705-6506
US

V. Phone/Fax

Practice location:
  • Phone: 714-617-2626
  • Fax: 714-667-8088
Mailing address:
  • Phone: 714-617-2626
  • Fax: 714-667-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberC137003
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC137003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: