Individual
DAVID PALOMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 WALTERS ST, LAKE CHARLES, LA 70607-4647
(337) 480-8066
(337) 480-8109
Mailing address
PO BOX 122108 DEPT 2108, DALLAS, TX 75312-0001
(337) 494-2772
(337) 494-2928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD206492
LA
207Q00000X
Family Medicine Physician
Q3415
TX
207QA0000X
Adolescent Medicine (Family Medicine) Physician
206492
LA
207QA0505X
Adult Medicine Physician
206492
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2199668
—
LA
01
—
MD.206492
STATE LICENSE
LA
Enumeration date
03/20/2012
Last updated
05/16/2024
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