Basic Information
| Provider Information | |||||||||
| NPI: | 1740424928 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EKOCHIN | ||||||||
| FirstName: | LEA | ||||||||
| MiddleName: | HILDA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2925 CHICAGO AVE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554071321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122625000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11269 JEFFERSON HWY N | ||||||||
| Address2: | |||||||||
| City: | CHAMPLIN | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553163123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7632360600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2009 | ||||||||
| LastUpdateDate: | 11/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 52657 | MN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.