Organization
CHRISTIAN A. MAYORGA, MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTIAN A MAYORGA M.D. (MEMBER)
(504) 305-0063
Entity
Organization
Contact information
Practice address
4228 WILLIAMS BLVD, STE 201, KENNER, LA 70065-2270
(504) 305-0063
Mailing address
4228 WILLIAMS BLVD, STE 201, KENNER, LA 70065-2270
(504) 305-0063
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
11181R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1662101
—
LA
Enumeration date
09/25/2009
Last updated
10/25/2011
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