Healthcare Provider Details

I. General information

NPI: 1760248140
Provider Name (Legal Business Name): TRUSTED DOCTORS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 CROFTON BLVD STE 301
CROFTON MD
21114-1387
US

IV. Provider business mailing address

13135 ROUTE 50 STE 300
FAIRFAX VA
22033-1907
US

V. Phone/Fax

Practice location:
  • Phone: 410-263-6363
  • Fax: 410-263-7551
Mailing address:
  • Phone: 703-322-0245
  • Fax: 703-666-3762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SANDY CHUNG
Title or Position: CEO
Credential: MD
Phone: 703-322-0245