Organization
GULF COAST NEPHROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA DEL TORO (OFFICER OF THE COMPANY)
(337) 288-5557
Entity
Organization
Contact information
Practice address
300 18TH ST STE 200, LAKE CHARLES, LA 70601-7342
(337) 497-0366
(337) 497-1367
Mailing address
300 W SAINT MARY BLVD, LAFAYETTE, LA 70506-4638
(337) 288-5557
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2602616
—
LA
Enumeration date
05/05/2022
Last updated
03/15/2024
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