Provider Demographics
NPI:1912180233
Name:GHAZAL, BAHIJ (MD)
Entity Type:Individual
Prefix:
First Name:BAHIJ
Middle Name:
Last Name:GHAZAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 E HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3776
Mailing Address - Country:US
Mailing Address - Phone:626-254-2293
Mailing Address - Fax:
Practice Address - Street 1:440 E HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3776
Practice Address - Country:US
Practice Address - Phone:626-254-2293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123097208M00000X, 208M00000X
MO2010024513208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist