Healthcare Provider Details

I. General information

NPI: 1083323885
Provider Name (Legal Business Name): PATIENT CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 HIOAKS RD SUITE F/G
RICHMOND VA
23225
US

IV. Provider business mailing address

909 HIOAKS RD SUITE F/G
RICHMOND VA
23225
US

V. Phone/Fax

Practice location:
  • Phone: 949-696-6157
  • Fax:
Mailing address:
  • Phone: 949-696-6157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FAIZA AKBAR
Title or Position: OWNER
Credential: MD
Phone: 949-696-6157