| Fairfax Urgent Care Llc | |
|
8191 Strawberry Ln 4 Falls Church VA 22042-1031 | |
| (703) 658-2650 | |
| Not Available |
| Full Name | Fairfax Urgent Care Llc |
|---|---|
| Speciality | General Practice |
| Location | 8191 Strawberry Ln, Falls Church, Virginia |
| Authorized Official Name and Position | Ambrish Gupta (MANAGER) |
| Authorized Official Contact | 7036582650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax Urgent Care Llc 8191 Strawberry Ln 4 Falls Church VA 22042-1031 Ph: () - | Fairfax Urgent Care Llc 8191 Strawberry Ln 4 Falls Church VA 22042-1031 Ph: (703) 658-2650 |
| NPI Number | 1376823237 |
|---|---|
| Provider Enumeration Date | 08/24/2011 |
| Last Update Date | 11/02/2011 |
| Medicare PECOS PAC ID | 5991978215 |
|---|---|
| Medicare Enrollment ID | O20111102000584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376823237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jyotsna Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770517062 PECOS PAC ID: 7416968391 Enrollment ID: I20090513000156 |
| Provider Name | Ambrish Kumar Gupta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518991892 PECOS PAC ID: 9234140112 Enrollment ID: I20110211000299 |
| Provider Name | Kiren M Dayal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528091683 PECOS PAC ID: 3779687181 Enrollment ID: I20110531000012 |
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