Provider Demographics
NPI:1093075798
Name:OPTIMUM CARE LLC
Entity Type:Organization
Organization Name:OPTIMUM CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:KABIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-888-8100
Mailing Address - Street 1:9703 CARNOT WAY
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3013
Mailing Address - Country:US
Mailing Address - Phone:703-888-8100
Mailing Address - Fax:
Practice Address - Street 1:882 GARRISONVILLE RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-3907
Practice Address - Country:US
Practice Address - Phone:540-318-6464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-29
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty