Provider Demographics
NPI:1912989443
Name:KAIMAL, JANARDANA P (MD)
Entity Type:Individual
Prefix:DR
First Name:JANARDANA
Middle Name:P
Last Name:KAIMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4820 LAKE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-6010
Mailing Address - Country:US
Mailing Address - Phone:337-310-7378
Mailing Address - Fax:337-310-7382
Practice Address - Street 1:4820 LAKE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-6010
Practice Address - Country:US
Practice Address - Phone:337-310-7378
Practice Address - Fax:337-310-7382
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA3828R207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1179329Medicaid
LA1179329Medicaid
LA52822CB79Medicare PIN
LAB89563Medicare UPIN
LA290013531Medicare PIN