Provider Demographics
NPI:1487630067
Name:GUO, JING (OD)
Entity Type:Individual
Prefix:DR
First Name:JING
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:650 MASSACHUSETTS AVE NW STE 140
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3796
Practice Address - Country:US
Practice Address - Phone:202-898-1060
Practice Address - Fax:202-898-0472
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000958152W00000X
MDDA2396152W00000X
DCOP1000013152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist