Provider Demographics
NPI:1457075558
Name:ALRAJAAN, FARAH
Entity Type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:ALRAJAAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 BROOKE CT UNIT 407
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5286
Mailing Address - Country:US
Mailing Address - Phone:310-570-8281
Mailing Address - Fax:
Practice Address - Street 1:5814 VAN ALLEN WAY STE 225
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7366
Practice Address - Country:US
Practice Address - Phone:310-570-8281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1360208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice