DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: PRIMARY GERONTOLOGY CENTER LLC

MEDICARE: PRIMARY GERONTOLOGY CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QG0300XGeriatric Medicine (Family Medicine) PhysicianVA

General Provider Information

NPI Number : 1215425384
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIMARY GERONTOLOGY CENTER LLC
Provider Business Mailing Address
First Line : 4216 EVERGREEN LN STE 121
Second Line :
City : ANNANDALE
State : VA
Zip : 22003-3256
Country : US
Telephone Number : 571-206-1650
Fax Number : 703-662-6165
Provider Business Practice Location Address
First Line : 4216 EVERGREEN LN STE 125
Second Line :
City : ANNANDALE
State : VA
Zip : 22003-3256
Country : US
Telephone Number : 571-206-1650
Fax Number : 703-662-6165
Authorized Official
Title or Position : OWNER/STAFF PHYSICIAN
Name : JIHO CHOI
Credential : MD
Telephone Number : 571-206-1650
Provider Enumeration Date : 04/24/2018
Last Update Date : 03/14/2026

Similar Medicare Providers

1437314622 — LISA MARIE FISHER PT
Practice Location Address:
4216 EVERGREEN LN STE 121
ANNANDALE, VA
22003-3256
Practice Phone: 571-276-9337
Practice Fax: 571-234-6232
1811250293 — DR. JORGE I RAMALLO M.D.
Practice Location Address:
4216 EVERGREEN LN STE 121
ANNANDALE, VA
22003-3256
Practice Phone: 703-434-0749
Practice Fax: 888-671-8837
1497101885 — WOO HYUNG SHIN
Practice Location Address:
4216 EVERGREEN LN STE 121
ANNANDALE, VA
22003-3256
Practice Phone: 703-591-3333
Practice Fax:
1699396036 — LITTLE RIVER PHYSICAL THERAPY LLC
Practice Location Address:
4216 EVERGREEN LN STE 121
ANNANDALE, VA
22003-3256
Practice Phone: 571-276-9337
Practice Fax: 571-234-6232
1366043317 — GOLGOTA HEALTH SERVICES INC
Practice Location Address:
4216 EVERGREEN LN STE 133
ANNANDALE, VA
22003-3256
Practice Phone: 443-286-9323
Practice Fax:
1861191025 — TEN PRO CLINIC
Practice Location Address:
4216 EVERGREEN LN STE 121
ANNANDALE, VA
22003-3256
Practice Phone: 703-829-6162
Practice Fax: 703-662-6165

Directions to “PRIMARY GERONTOLOGY CENTER LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.