Provider Demographics
NPI:1497138002
Name:ALWAHAB, AREEJ (MD)
Entity type:Individual
Prefix:
First Name:AREEJ
Middle Name:
Last Name:ALWAHAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E CHASE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-6305
Mailing Address - Country:US
Mailing Address - Phone:619-399-7878
Mailing Address - Fax:855-499-5006
Practice Address - Street 1:250 E CHASE AVE STE 110
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-6305
Practice Address - Country:US
Practice Address - Phone:619-399-7878
Practice Address - Fax:855-499-5006
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301501066208000000X
CAA166758208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301501066OtherSTATE LICENSE
CAA166758OtherSTATE LICENSE