MEDICARE: ALYSSA KARREN CHOO PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0110009739	VA
2	363A00000X	Physician Assistant	C0009457	MD

General Provider Information

NPI Number	:	1700568490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA KARREN CHOO PA-C

Provider Business Mailing Address
First Line	:	1400 FOREST GLEN RD STE 400
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-1482
Country	:	US
Telephone Number	:	301-589-3324
Fax Number	:	301-681-7575

Provider Business Practice Location Address
First Line	:	1400 FOREST GLEN RD STE 400
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-1482
Country	:	US
Telephone Number	:	301-589-3324
Fax Number	:	301-681-7575

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2023
Last Update Date	:	08/26/2024

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