MEDICARE: WALID FARAJ, D.O., A PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1033073416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALID FARAJ, D.O., A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	11121 LOS ALAMITOS BLVD STE 201
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3889
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11121 LOS ALAMITOS BLVD STE 201
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3889
Country	:	US
Telephone Number	:	714-230-2424
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	WALID FARAJ
Credential	:	DO
Telephone Number	:	714-230-2424

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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