Provider Demographics
NPI:1790806370
Name:ANTOINE J ELHAJJAR M.D., INC.
Entity Type:Organization
Organization Name:ANTOINE J ELHAJJAR M.D., INC.
Other - Org Name:DESERT SLEEP INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTOINE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ELHAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-340-0528
Mailing Address - Street 1:46100 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2042
Mailing Address - Country:US
Mailing Address - Phone:760-340-0528
Mailing Address - Fax:760-674-1590
Practice Address - Street 1:46100 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-2042
Practice Address - Country:US
Practice Address - Phone:760-340-0528
Practice Address - Fax:760-674-1590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084N0400X
CAA53481261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty