Provider Demographics
NPI:1932141520
Name:ELHAJ, ALAA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAA
Middle Name:
Last Name:ELHAJ
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 1:2001 DWIGHT WAY STE 4190
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-2608
Mailing Address - Country:US
Mailing Address - Phone:510-204-4635
Mailing Address - Fax:510-204-3060
Practice Address - Street 1:2001 DWIGHT WAY STE 4190
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2608
Practice Address - Country:US
Practice Address - Phone:510-204-4635
Practice Address - Fax:510-204-3060
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1443142084P0800X
MO20040354152084P0800X
KS04328212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200337290BMedicaid
KS200337290BMedicaid
KA1206001Medicare PIN