Healthcare Provider Details

I. General information

NPI: 1891566840
Provider Name (Legal Business Name): ANH NGUYEN OPHTHALMIC SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6402 ARLINGTON BLVD STE 600
FALLS CHURCH VA
22042-2343
US

IV. Provider business mailing address

6402 ARLINGTON BLVD STE 600
FALLS CHURCH VA
22042-2343
US

V. Phone/Fax

Practice location:
  • Phone: 703-534-4393
  • Fax:
Mailing address:
  • Phone: 703-534-4393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANH NGUYEN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 703-534-4393