Basic Information
| Provider Information | |||||||||
| NPI: | 1487676243 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAMBOJ | ||||||||
| FirstName: | SANJAY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1542 TULANE AVE, BOX T4M-2 | ||||||||
| Address2: | LSUHSC- S. KAMBOJ | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5045685722 | ||||||||
| FaxNumber: | 5045672127 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 WEST ESPLANADE AVE, STE 205 | ||||||||
| Address2: | LSUHN MULTISPECIALTY CLINIC/S. KABBOJ | ||||||||
| City: | KENNER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044121705 | ||||||||
| FaxNumber: | 5044121726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 10/26/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 26647 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207R00000X | MD026647 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207K00000X | MD026647 | LA | N | Allopathic & Osteopathic Physicians | Allergy & Immunology | 208M00000X | MD026647 | LA | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 1421197 | 05 | LA | MEDICAID |