Provider Demographics
NPI:1669210902
Name:ALLAB MEDICAL CLINIC
Entity type:Organization
Organization Name:ALLAB MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALAA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOUEFETOUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:840-256-7730
Mailing Address - Street 1:10470 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:RCH CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3754
Mailing Address - Country:US
Mailing Address - Phone:840-256-7730
Mailing Address - Fax:
Practice Address - Street 1:10470 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:RCH CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3754
Practice Address - Country:US
Practice Address - Phone:840-256-7730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty