Provider Demographics
NPI:1730667973
Name:CALCASIEU LUNG AND SLEEP LLC
Entity Type:Organization
Organization Name:CALCASIEU LUNG AND SLEEP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALLAGOLLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-376-2438
Mailing Address - Street 1:1327 STELLY LN STE 2
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-5650
Mailing Address - Country:US
Mailing Address - Phone:626-376-2438
Mailing Address - Fax:
Practice Address - Street 1:1327 STELLY LN STE 2
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-5650
Practice Address - Country:US
Practice Address - Phone:626-376-2438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty