| Sunset Medical Clinic Llc | |
|
990 Napoleon Avenue Sunset LA 70584-6100 | |
| (337) 662-7290 | |
| Not Available |
| Full Name | Sunset Medical Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 990 Napoleon Avenue, Sunset, Louisiana |
| Authorized Official Name and Position | Randy James Daigle (PARTNER/MD) |
| Authorized Official Contact | 3376627290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunset Medical Clinic Llc 990 Napoleon Avenue Sunset LA 70584-6100 Ph: (337) 662-7290 | Sunset Medical Clinic Llc 990 Napoleon Avenue Sunset LA 70584-6100 Ph: (337) 662-7290 |
| NPI Number | 1093702367 |
|---|---|
| Provider Enumeration Date | 10/03/2005 |
| Last Update Date | 11/23/2010 |
| Medicare PECOS PAC ID | 2062468994 |
|---|---|
| Medicare Enrollment ID | O20050324000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093702367 | NPI | - | NPPES |
| 1943142 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marcelo G Polanco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982789194 PECOS PAC ID: 8729055629 Enrollment ID: I20040911000037 |
| Provider Name | Jimmy Legros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063419745 PECOS PAC ID: 4880798404 Enrollment ID: I20070409000238 |
| Provider Name | Randy Daigle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558361865 PECOS PAC ID: 8628174661 Enrollment ID: I20100920000546 |
| Provider Name | Khaled S Qaisieh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750842100 PECOS PAC ID: 9436487246 Enrollment ID: I20190817000006 |
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