Individual
ANTONIO BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 OPITZ BLVD, WOODBRIDGE, VA 22191-3311
(216) 288-1596
Mailing address
5705 FAIRFAX DR, ARLINGTON, VA 22205-2305
(216) 288-1596
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101250082
VA
Other
Enumeration date
05/07/2008
Last updated
08/20/2013
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