Organization
CHILDREN & ADOLESCENT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PADMINI GUPTA M.D. (MEDICAL DIRECTOR)
(337) 643-8400
Entity
Organization
Contact information
Practice address
801 N MONTGOMERY AVE, KAPLAN, LA 70548-2007
(337) 643-8400
(337) 643-1544
Mailing address
801 N MONTGOMERY AVE, KAPLAN, LA 70548-2007
(337) 643-8400
(337) 643-1544
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
MD.05415R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316989
—
LA
Enumeration date
05/28/2008
Last updated
05/28/2008
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