Provider Demographics
NPI:1356171466
Name:ERICK GAITAN DC PC
Entity type:Organization
Organization Name:ERICK GAITAN DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GAITAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:202-813-0445
Mailing Address - Street 1:7911 WESTPARK DR APT 928
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-4283
Mailing Address - Country:US
Mailing Address - Phone:202-813-0445
Mailing Address - Fax:
Practice Address - Street 1:4123 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1155
Practice Address - Country:US
Practice Address - Phone:202-265-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty