Healthcare Provider Details

I. General information

NPI: 1184735334
Provider Name (Legal Business Name): LAN CHAU TU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAN CHAU HANG-TU MD

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6404 SEVEN CORNERS PLACE #G
FALLS CHURCH VA
22044-2304
US

IV. Provider business mailing address

6404 SEVEN CORNERS PLACE #G
FALLS CHURCH VA
22044-2034
US

V. Phone/Fax

Practice location:
  • Phone: 703-237-2488
  • Fax: 703-237-2492
Mailing address:
  • Phone: 703-237-2488
  • Fax: 703-237-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number0101-045181
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: