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General NPI Number Information
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NPI Number | 1598712150
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Entity Type | Organization
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Legal Business Name | MY HOA KAAS DPM PC
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 2826 OLD LEE HIGHWAY #220
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City | FAIRFAX
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State | VA
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Zip | 22031-4323
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Country | US
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Telephone | 703-205-0770
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Fax | 703-205-0771
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Provider Business Mailing Address
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Address Line | 2826 OLD LEE HIGHWAY #220
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City | FAIRFAX
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State | VA
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Zip | 22031-4348
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Country | US
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Telephone | 703-205-0770
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Fax | 703-205-0771
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | DR. MY HOA KAAS
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Credential | DPM
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Telephone | 703-205-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 1PD0031143
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License Number State | VA
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