Gamborg, Brian

Gamborg, Brian is an individual health care provider with primary practice located at 1525 Oak Park Blvd , Lake Charles LA 70601-8849. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gamborg, Brian can be contacted via phone (337) 494-6767.

Contact Information

Primary practice address
1525 Oak Park Blvd Lake Charles LA 70601-8849
Phone: (337) 494-6767
Fax: (337) 494-6750
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 023359 Louisiana

Profile Details

NPI number 1295795755
LBN Legal business name Gamborg, Brian
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Apr 29th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295795755 NPPES
Louisiana MEDICAID 1694878

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