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General NPI Number Information
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NPI Number | 1356532402
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Entity Type | Organization
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Legal Business Name | LSU/OCHSNER RESIDENCY PROGRAM
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 08/05/2007
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Provider Practice Location Address
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Address Line | 2020 GRAVIER ST
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City | NEW ORLEANS
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State | LA
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Zip | 70112-2272
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Country | US
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Telephone | 504-952-6112
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Fax |
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Provider Business Mailing Address
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Address Line | 5219 CITRUS BLVD APT R127
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City | RIVER RIDGE
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State | LA
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Zip | 70123-7221
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Country | US
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Telephone | 504-952-6112
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | DR. SOYEON CHIN
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Credential | PHD, MD
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Telephone | 504-952-6112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | PGY2LSUNOOPH
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License Number State | LA
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