Provider Demographics
NPI:1760670277
Name:DAREK L GUICHARD
Entity Type:Organization
Organization Name:DAREK L GUICHARD
Other - Org Name:TOTAL FOOT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAREK
Authorized Official - Middle Name:
Authorized Official - Last Name:GUICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:985-651-6096
Mailing Address - Street 1:179 BELLE TERRE BLVD
Mailing Address - Street 2:STE. A
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-3347
Mailing Address - Country:US
Mailing Address - Phone:985-651-6096
Mailing Address - Fax:
Practice Address - Street 1:179 BELLE TERRE BLVD
Practice Address - Street 2:STE. A
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3347
Practice Address - Country:US
Practice Address - Phone:985-651-6096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD091R213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0545680001Medicare NSC
LA57751Medicare PIN