Provider Demographics
NPI:1700058369
Name:SLEEP DISORDER CENTER OF LOUISIANA, LLC
Entity Type:Organization
Organization Name:SLEEP DISORDER CENTER OF LOUISIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SUPERVISING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JANARDANA
Authorized Official - Middle Name:P
Authorized Official - Last Name:KAIMAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-310-7378
Mailing Address - Street 1:PO BOX 4591
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70606-4591
Mailing Address - Country:US
Mailing Address - Phone:337-310-7378
Mailing Address - Fax:337-310-7382
Practice Address - Street 1:422 KADE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-3638
Practice Address - Country:US
Practice Address - Phone:337-310-7378
Practice Address - Fax:337-310-7382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DA53Medicare PIN