| Shangri-la Integrated Clinic | |
|
13890 Braddock Rd Ste 300 Centreville VA 20121-2438 | |
| (571) 655-2281 | |
| Not Available |
| Full Name | Shangri-la Integrated Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 13890 Braddock Rd Ste 300, Centreville, Virginia |
| Authorized Official Name and Position | Chung Do Kim (DIRECTOR) |
| Authorized Official Contact | 5712182393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shangri-la Integrated Clinic 13890 Braddock Rd Ste 300 Centreville VA 20121-2438 Ph: (571) 655-2281 | Shangri-la Integrated Clinic 13890 Braddock Rd Ste 300 Centreville VA 20121-2438 Ph: (571) 655-2281 |
| NPI Number | 1336707553 |
|---|---|
| Provider Enumeration Date | 06/03/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336707553 | NPI | - | NPPES |
| 0121000910 | Other | VA | N/A |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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