| Choca Md Llc | |
|
418 Albertson Pkwy Broussard LA 70518-4971 | |
| (337) 237-6444 | |
| Not Available |
| Full Name | Choca Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 418 Albertson Pkwy, Broussard, Louisiana |
| Authorized Official Name and Position | Edgar Pumarol -castillo (SOLE MEMBER/OWNER) |
| Authorized Official Contact | 3375349286 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Choca Md Llc Po Box 82281 Lafayette LA 70598-2281 Ph: (337) 534-9286 | Choca Md Llc 418 Albertson Pkwy Broussard LA 70518-4971 Ph: (337) 237-6444 |
| NPI Number | 1235670993 |
|---|---|
| Provider Enumeration Date | 03/14/2017 |
| Last Update Date | 03/14/2017 |
| Medicare PECOS PAC ID | 1759667322 |
|---|---|
| Medicare Enrollment ID | O20170413001850 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235670993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 208224 (Louisiana) | Primary |
| Provider Name | Edgar Pumarol Castillo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285981183 PECOS PAC ID: 1557502788 Enrollment ID: I20151110002901 |
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