Ramin Shahla, MD

Individual provider Active NPI Psychiatry Physician · Lake Charles, LA

NPI 1336249762 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1336249762
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
12273R (LA)
Practice address
2837 Ernest Street
Calcacien Oak Hospital
Lake Charles, LA 70601
Phone
(337) 439-8111
Fax
(337) 439-1970
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12273RLAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Department of Health, Department of Health and Hospitals Past Accepting new patients
Psychiatric Center LLC Psychiatry Past
since Sep 26, 2010
Accepting new patients
Telecare Corporation Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 12273R LA Yes

Addresses

Primary practice location

2837 Ernest Street
Calcacien Oak Hospital
Lake Charles, LA 70601

Mailing address

PO Box 2262
Lake Charles, LA 70602
Phone (504) 236-1525

Other identifiers

IdentifierTypeStateIssuer
1485799MedicaidLA

Other providers in Lake Charles, LA

All providers in Lake Charles, LA · Psychiatry Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.