Provider Demographics
NPI:1578087292
Name:XENON HEALTH OF LOUISIANA LLC
Entity Type:Organization
Organization Name:XENON HEALTH OF LOUISIANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:HAROON
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-417-0335
Mailing Address - Street 1:6464 W SUNSET BLVD STE 790
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-8006
Mailing Address - Country:US
Mailing Address - Phone:323-417-0335
Mailing Address - Fax:323-978-6136
Practice Address - Street 1:3867 PLAZA TOWER DR FL 1
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4378
Practice Address - Country:US
Practice Address - Phone:323-417-0335
Practice Address - Fax:323-978-6136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-03
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========OtherTAX ID