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General NPI Number Information
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NPI Number | 1407939549
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Entity Type | Organization
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Legal Business Name | MCLEAN CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE, PLC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8214 OLD COURTHOUSE RD
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City | VIENNA
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State | VA
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Zip | 22182-3885
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Country | US
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Telephone | 703-499-4428
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Fax | 703-547-8197
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Provider Business Mailing Address
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Address Line | 8214 OLD COURTHOUSE RD
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City | VIENNA
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State | VA
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Zip | 22182-3885
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Country | US
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Telephone | 703-499-4428
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Fax | 703-547-8197
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARTHUR Y FAN
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Credential | LAC
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Telephone | 703-499-4428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC30091
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0121000278
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License Number State | VA
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