Provider Demographics
NPI:1043287345
Name:HAJJ, AHMAD A (MD)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:A
Last Name:HAJJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1220 HEMLOCK WAY
Mailing Address - Street 2:STE 203
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3650
Mailing Address - Country:US
Mailing Address - Phone:714-957-5721
Mailing Address - Fax:714-957-5872
Practice Address - Street 1:1220 HEMLOCK WAY
Practice Address - Street 2:STE 203
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3650
Practice Address - Country:US
Practice Address - Phone:714-957-5721
Practice Address - Fax:714-957-5872
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC40971207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0063390Medicaid
CAWC40971AMedicare ID - Type Unspecified
A37490Medicare UPIN