# THE PRIMARY CARE GROUP OF EAST JEFFERSON, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588735393
- **Authorized official:** LAUREN A SANTA ANA MHA, MBA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (504) 454-5396

## Contact information

- **Practice address:** 4315 HOUMA BLVD, SUITE 204, METAIRIE, LA 70006-2940
- **Practice address phone:** (504) 454-5396
- **Practice address fax:** (504) 456-8151
- **Mailing address:** 4420 CONLIN ST, SUITE 304, METAIRIE, LA 70006-2167
- **Mailing address phone:** (504) 454-5396
- **Mailing address fax:** (504) 456-8151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/13/2006
- **Last updated:** 08/22/2020