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Organization

JASMINE MOGHISSI, M.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JASMINE MOGHISSI MD (PRESIDENT)
(703) 281-5560
Entity
Organization

Contact information

Practice address
9401 LEE HWY, SUITE 302, FAIRFAX, VA 22031-1849
(703) 281-5560
(703) 281-5568
Mailing address
9401 LEE HWY, SUITE 302, FAIRFAX, VA 22031-1849
(703) 281-5560
(703) 281-5568

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101044043
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DF2854 / P00353016
MEDICARE RAILROAD
Enumeration date
08/15/2007
Last updated
08/03/2009
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