Healthcare Provider Details

I. General information

NPI: 1831878024
Provider Name (Legal Business Name): GLOBAL CENTER FOR AUTISM SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 10/19/2024
Certification Date: 10/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4485 FORBES BLVD
LANHAM MD
20706-4354
US

IV. Provider business mailing address

4485 FORBES BLVD
LANHAM MD
20706-4354
US

V. Phone/Fax

Practice location:
  • Phone: 301-429-2900
  • Fax:
Mailing address:
  • Phone: 301-429-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SALVADOR TAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 301-429-2900