Healthcare Provider Details

I. General information

NPI: 1861173767
Provider Name (Legal Business Name): HAPPY MEDICAL CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7610 CARROLL AVE STE 260
TAKOMA PARK MD
20912-6302
US

IV. Provider business mailing address

7610 CARROLL AVE STE 260
TAKOMA PARK MD
20912-6302
US

V. Phone/Fax

Practice location:
  • Phone: 301-326-1916
  • Fax: 301-326-1923
Mailing address:
  • Phone: 301-326-1916
  • Fax: 301-326-1923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CYRIAC NCHANG
Title or Position: C0 - PRESIDENT
Credential: CRNP, DNP
Phone: 240-645-3624