Provider Demographics
NPI:1790915056
Name:LOEHMANN'S WALK-IN CLINIC PLLC
Entity Type:Organization
Organization Name:LOEHMANN'S WALK-IN CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HOANG
Authorized Official - Middle Name:V
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-846-9555
Mailing Address - Street 1:7283 ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3200
Mailing Address - Country:US
Mailing Address - Phone:703-846-9555
Mailing Address - Fax:703-846-9556
Practice Address - Street 1:7283 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3200
Practice Address - Country:US
Practice Address - Phone:703-846-9555
Practice Address - Fax:703-846-9556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0955195207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5825865Medicaid
VAG31497Medicare UPIN