Kakazu, Mario

Kakazu, Mario is an sole proprietor health care provider with primary practice located at 2552 Williams Blvd , Kenner LA 70062-5538. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Kakazu, Mario can be contacted via phone (504) 463-3002.

Contact Information

Primary practice address
2552 Williams Blvd Kenner LA 70062-5538
Phone: (504) 463-3002
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 05311R Louisiana
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X MD.05311R Louisiana
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1366421562
LBN Legal business name Kakazu, Mario
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2006
Last updated Jun 30th, 2021 - 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 1366421562 NPPES
Louisiana MEDICAID 1317128
Louisiana Other G6438

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