Provider Demographics
NPI:1760890446
Name:HEGAB, ALAA (MBBCH)
Entity Type:Individual
Prefix:DR
First Name:ALAA
Middle Name:
Last Name:HEGAB
Suffix:
Gender:M
Credentials:MBBCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 UNIVERSITY AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1713
Mailing Address - Country:US
Mailing Address - Phone:650-644-1833
Mailing Address - Fax:
Practice Address - Street 1:270 UNIVERSITY AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-1713
Practice Address - Country:US
Practice Address - Phone:650-644-1833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-26
Last Update Date:2014-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME104376207K00000X, 208000000X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology