Provider Demographics
NPI:1437611464
Name:ALJAMMAL, ANAS M (MD)
Entity type:Individual
Prefix:DR
First Name:ANAS
Middle Name:M
Last Name:ALJAMMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:370 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-2322
Mailing Address - Country:US
Mailing Address - Phone:949-557-0610
Mailing Address - Fax:949-557-0611
Practice Address - Street 1:370 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-2322
Practice Address - Country:US
Practice Address - Phone:949-557-0610
Practice Address - Fax:949-557-0611
Is Sole Proprietor?:No
Enumeration Date:2019-03-31
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA178322207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine