# FAIRFAX URGENT CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376823237
- **Authorized official:** AMBRISH GUPTA M.D. (MANAGER)
- **Authorized official phone:** (703) 658-2650

## Contact information

- **Practice address:** 8191 STRAWBERRY LN, 4, FALLS CHURCH, VA 22042-1031
- **Practice address phone:** (703) 658-2650
- **Mailing address:** 8191 STRAWBERRY LN, 4, FALLS CHURCH, VA 22042-1031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/24/2011
- **Last updated:** 11/02/2011