MEDICARE: DR. ALIA ANNETTE NAJJAR M.D.

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	208D00000X	General Practice Physician	M2723	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0072NA	OTHER	TX	BLUE CROSS/BLUE SHIELD #

General Provider Information

NPI Number	:	1467443192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALIA ANNETTE NAJJAR M.D.

Provider Business Mailing Address
First Line	:	1737 SOLANO AVE APT 110
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94707-2210
Country	:	US
Telephone Number	:	832-443-1872
Fax Number	:

Provider Business Practice Location Address
First Line	:	1737 SOLANO AVE APT 110
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94707-2210
Country	:	US
Telephone Number	:	832-443-1872
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/08/2007

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