Provider Demographics
NPI:1104008820
Name:CLINICA FAMILIAR DE ARLINGTON PC
Entity Type:Organization
Organization Name:CLINICA FAMILIAR DE ARLINGTON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HOSSEIN
Authorized Official - Last Name:MOLAIY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-465-0137
Mailing Address - Street 1:1635 N GEORGE MASON DR
Mailing Address - Street 2:SUITE 455
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3601
Mailing Address - Country:US
Mailing Address - Phone:703-465-0137
Mailing Address - Fax:703-465-0429
Practice Address - Street 1:1635 N GEORGE MASON DR
Practice Address - Street 2:SUITE 455
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3601
Practice Address - Country:US
Practice Address - Phone:703-465-0137
Practice Address - Fax:703-465-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232384261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care