Healthcare Provider Details

I. General information

NPI: 1770158206
Provider Name (Legal Business Name): METRO GERONTOLOGY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16051 COMPRINT CIR
GAITHERSBURG MD
20877-1320
US

IV. Provider business mailing address

16051 COMPRINT CIR
GAITHERSBURG MD
20877-1320
US

V. Phone/Fax

Practice location:
  • Phone: 571-206-1650
  • Fax: 703-662-6165
Mailing address:
  • Phone: 571-206-1650
  • Fax: 703-662-6165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JIHO CHOI
Title or Position: OWNER
Credential: MD
Phone: 571-206-1650