Provider Demographics
NPI:1902206675
Name:BIOPOTENTIALS, L.L.C.
Entity Type:Organization
Organization Name:BIOPOTENTIALS, L.L.C.
Other - Org Name:BIOPOTENTIALS SLEEP CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WEIHONG
Authorized Official - Middle Name:
Authorized Official - Last Name:PAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:225-223-6899
Mailing Address - Street 1:3436 MAGAZINE ST # 8024
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-2413
Mailing Address - Country:US
Mailing Address - Phone:225-223-6899
Mailing Address - Fax:225-663-6458
Practice Address - Street 1:3436 MAGAZINE ST # 8024
Practice Address - Street 2:SUITE A
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-2413
Practice Address - Country:US
Practice Address - Phone:225-223-6899
Practice Address - Fax:225-663-6458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2017-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00917117207RS0012X, 332B00000X
LA13456R261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA00917117OtherOCCUPATION LICENSE
LA5H202Medicare PIN
LA00917117OtherOCCUPATIONAL LICENSE NUMBER
LAH12742Medicare UPIN
LA1481050Medicaid