| Virginia Advanced Medical Center, Pc | |
|
3930 Pender Dr Ste 320 Fairfax VA 22030-0986 | |
| (703) 817-7770 | |
| (703) 563-6274 |
| Full Name | Virginia Advanced Medical Center, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3930 Pender Dr Ste 320, Fairfax, Virginia |
| Authorized Official Name and Position | Chin Kim (PHYSICIAN) |
| Authorized Official Contact | 7038177770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Advanced Medical Center, Pc 3930 Pender Dr Ste 320 Fairfax VA 22030-0986 Ph: (703) 817-7770 | Virginia Advanced Medical Center, Pc 3930 Pender Dr Ste 320 Fairfax VA 22030-0986 Ph: (703) 817-7770 |
| NPI Number | 1942451695 |
|---|---|
| Provider Enumeration Date | 09/30/2008 |
| Last Update Date | 08/22/2011 |
| Medicare PECOS PAC ID | 3072671924 |
|---|---|
| Medicare Enrollment ID | O20090306000317 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942451695 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Chin Oh Kim |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1770636508 PECOS PAC ID: 5991805863 Enrollment ID: I20090306000301 |
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