Christian Antonio Mayorga, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11181R Issued in LA

Practice address

4228 Williams Blvd
Suite 201
Kenner, LA 70065-2270

Phone

(504) 305-0063

Fax

(504) 305-2366

NPI assigned

Dec 7, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253836800000",
    "number": "1235298050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 WILLIAMS BLVD",
            "address_2": "SUITE 201",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652270",
            "telephone_number": "504-305-0063",
            "fax_number": "504-305-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 WILLIAMS BLVD",
            "address_2": "SUITE 201",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652270",
            "telephone_number": "504-305-0063",
            "fax_number": "504-305-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYORGA",
        "first_name": "CHRISTIAN",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2009-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "11181R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1662101",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee H Matthews, PH.D.
• Maria F Matute
• Caroline Mayer Coleman, PT, DPT
• Simone Mayer
• Jesse Collin Maynor
• Danielle McAllister
• Jeannie R McCartney
• Cory S McClinton, PA-C
• Princess La Faye McCormick-Lynch
• Laura Folse McCormick, M.D.

• Family Medicine Physician in Kenner, LA
• Providers in Kenner, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.