Provider Demographics
NPI:1003103805
Name:HAJAR, RABAB (MD)
Entity Type:Individual
Prefix:
First Name:RABAB
Middle Name:
Last Name:HAJAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RABAB
Other - Middle Name:
Other - Last Name:HAJAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:35 CASA ST STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-1887
Mailing Address - Country:US
Mailing Address - Phone:805-541-1422
Mailing Address - Fax:805-595-1815
Practice Address - Street 1:35 CASA ST STE 130
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-1887
Practice Address - Country:US
Practice Address - Phone:805-541-1422
Practice Address - Fax:805-595-1815
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133570207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty