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General NPI Number Information
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NPI Number | 1750993663
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Entity Type | Organization
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Legal Business Name | LJ MEDICAL LLC
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 121 CONGRESSIONAL LN STE 204
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City | ROCKVILLE
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State | MD
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Zip | 20852-1542
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Country | US
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Telephone | 301-917-4139
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Fax | 877-803-4509
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Provider Business Mailing Address
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Address Line | 121 CONGRESSIONAL LN STE 204
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City | ROCKVILLE
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State | MD
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Zip | 20852-1542
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Country | US
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Telephone | 301-917-4139
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Fax | 877-803-4509
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Authorized Official
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Title or Position | CEO
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Name | MALVIS TAMON
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Credential | MD
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Telephone | 240-426-3316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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