Healthcare Provider Details

I. General information

NPI: 1740323823
Provider Name (Legal Business Name): JANARDANA P. KAIMAL, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 LAKE ST
LAKE CHARLES LA
70605-6010
US

IV. Provider business mailing address

PO BOX 4591
LAKE CHARLES LA
70606-4591
US

V. Phone/Fax

Practice location:
  • Phone: 337-310-7378
  • Fax: 337-310-7382
Mailing address:
  • Phone: 337-436-7560
  • Fax: 337-433-9861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number3828R
License Number StateLA

VIII. Authorized Official

Name: DR. JANARDANA PARAMESWARA KAIMAL
Title or Position: OWNER
Credential: MD
Phone: 337-310-7278