Provider Demographics
NPI:1497316269
Name:PRESTIGE MEDICAL HOUSE CALL LLC
Entity Type:Organization
Organization Name:PRESTIGE MEDICAL HOUSE CALL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:703-352-1959
Mailing Address - Street 1:8315 LEE HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2215
Mailing Address - Country:US
Mailing Address - Phone:703-352-1959
Mailing Address - Fax:703-352-2294
Practice Address - Street 1:8315 LEE HWY STE 202
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2215
Practice Address - Country:US
Practice Address - Phone:703-352-1959
Practice Address - Fax:703-352-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty