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General NPI Number Information
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NPI Number | 1104008820
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Entity Type | Organization
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Legal Business Name | CLINICA FAMILIAR DE ARLINGTON PC
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 1635 N GEORGE MASON DR SUITE 455
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City | ARLINGTON
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State | VA
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Zip | 22205-3601
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Country | US
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Telephone | 703-465-0137
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Fax | 703-465-0429
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Provider Business Mailing Address
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Address Line | 1635 N GEORGE MASON DR SUITE 455
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City | ARLINGTON
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State | VA
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Zip | 22205-3601
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Country | US
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Telephone | 703-465-0137
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Fax | 703-465-0429
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JOHN HOSSEIN MOLAIY
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Credential | M.D.
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Telephone | 703-465-0137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 0101232384
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License Number State | VA
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