Provider Demographics
NPI:1801257720
Name:IMMEDIATE HOUSECALLS, LLC
Entity type:Organization
Organization Name:IMMEDIATE HOUSECALLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/STAFF PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JIHO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-920-0048
Mailing Address - Street 1:4216 EVERGREEN LN STE 121
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3256
Mailing Address - Country:US
Mailing Address - Phone:301-893-4124
Mailing Address - Fax:703-662-6165
Practice Address - Street 1:3459 SAINT JOHNS LN
Practice Address - Street 2:STE 9
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042
Practice Address - Country:US
Practice Address - Phone:301-893-4124
Practice Address - Fax:703-662-6165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-20
Last Update Date:2020-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X, 225700000X
MDD0081318207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD488375Medicare UPIN