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General NPI Number Information
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NPI Number | 1275783235
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Entity Type | Organization
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Legal Business Name | ADVANCED RETINA CENTER, LC
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 8233 OLD COURTHOUSE RD SUITE 300
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City | VIENNA
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State | VA
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Zip | 22182-3816
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Country | US
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Telephone | 703-917-0012
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Fax | 703-917-0028
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Provider Business Mailing Address
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Address Line | 8233 OLD COURTHOUSE RD SUITE 300
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City | VIENNA
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State | VA
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Zip | 22182-3816
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Country | US
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Telephone | 703-917-0012
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Fax | 703-917-0028
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Authorized Official
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Title or Position | MEMBER-MANAGER
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Name | JUNG J. WOO
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Credential | M.D.
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Telephone | 703-917-0012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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