Provider Demographics
NPI:1558682567
Name:GACHOKA, DAVID N (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:GACHOKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 N WOODLAWN AVE APT A
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-4760
Mailing Address - Country:US
Mailing Address - Phone:619-309-9544
Mailing Address - Fax:
Practice Address - Street 1:704 N WOODLAWN AVE APT A
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-4760
Practice Address - Country:US
Practice Address - Phone:619-309-9544
Practice Address - Fax:419-383-3108
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA305505207R00000X
390200000X
OH35.120488207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program