Individual
CHRISTIAN ANTONIO MAYORGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4228 WILLIAMS BLVD, SUITE 201, KENNER, LA 70065-2270
(504) 305-0063
(504) 305-2366
Mailing address
4228 WILLIAMS BLVD, SUITE 201, KENNER, LA 70065-2270
(504) 305-0063
(504) 305-2366
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11181R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1662101
—
LA
Enumeration date
12/07/2006
Last updated
09/25/2009
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