Provider Demographics
NPI:1457786873
Name:KEVIN INVESTMENTS INCORPORATION
Entity Type:Organization
Organization Name:KEVIN INVESTMENTS INCORPORATION
Other - Org Name:DIAGNOSTIC IMAGING CENTER OF MARRERO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KUNDAN
Authorized Official - Middle Name:LAL
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-349-9011
Mailing Address - Street 1:5001 LAPALCO BLVD
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4235
Mailing Address - Country:US
Mailing Address - Phone:504-349-9011
Mailing Address - Fax:504-349-4913
Practice Address - Street 1:5001 LAPALCO BLVD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-4235
Practice Address - Country:US
Practice Address - Phone:504-349-9011
Practice Address - Fax:504-349-4913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.07718R2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1911445Medicare PIN