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General NPI Number Information
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NPI Number | 1962946756
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE CARE CLINICS
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Dates
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Enumeration Date | 12/13/2016
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 3022 WILLIAMS DRIVE SUITE 100
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City | FAIRFAX
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State | VA
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Zip | 22031
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Country | US
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Telephone | 703-698-9400
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Fax | 703-698-9403
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Provider Business Mailing Address
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Address Line | 3022 WILLIAMS DRIVE SUITE 100
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City | FAIRFAX
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State | VA
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Zip | 22031
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Country | US
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Telephone | 703-698-9400
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Fax | 703-698-9403
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Authorized Official
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Title or Position | OWNER
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Name | NAVEEN DOKI
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Credential | M.D.
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Telephone | 703-698-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 0101251504
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License Number State | VA
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