Provider Demographics
NPI:1023831682
Name:ALAA HAJAL MD
Entity type:Organization
Organization Name:ALAA HAJAL MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-382-5390
Mailing Address - Street 1:11660 CHURCH ST APT 166
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8927
Mailing Address - Country:US
Mailing Address - Phone:586-382-5390
Mailing Address - Fax:
Practice Address - Street 1:1111 GRAND AVE STE L
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4172
Practice Address - Country:US
Practice Address - Phone:909-551-0205
Practice Address - Fax:909-345-7084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty