| La Primary Care | |
|
2701 N Causeway Blvd Metairie LA 70002-6029 | |
| (504) 301-0100 | |
| Not Available |
| Full Name | La Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 2701 N Causeway Blvd, Metairie, Louisiana |
| Authorized Official Name and Position | Vivian Mai Vu (OWNER) |
| Authorized Official Contact | 5043010100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Primary Care 2701 N Causeway Blvd Metairie LA 70002-6029 Ph: (504) 301-0100 | La Primary Care 2701 N Causeway Blvd Metairie LA 70002-6029 Ph: (504) 301-0100 |
| NPI Number | 1841605367 |
|---|---|
| Provider Enumeration Date | 06/23/2014 |
| Last Update Date | 09/22/2014 |
| Medicare PECOS PAC ID | 5294954921 |
|---|---|
| Medicare Enrollment ID | O20140911001558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841605367 | NPI | - | NPPES |
| 1121240 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD.203799 (Louisiana) | Primary |
| Provider Name | Clayton G Mazoue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982808762 PECOS PAC ID: 3375690621 Enrollment ID: I20090402000553 |
| Provider Name | Vivian M Vu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952578106 PECOS PAC ID: 3870626682 Enrollment ID: I20100730000559 |
| Provider Name | Jamie T Vu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487229340 PECOS PAC ID: 5799187910 Enrollment ID: I20210712000954 |
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