Sunil M. Dissanayake Md A Professional Corporation | |
1612 Nogales St Rowland Heights CA 91748-2257 | |
(626) 965-1646 | |
(626) 965-4697 |
Full Name | Sunil M. Dissanayake Md A Professional Corporation |
---|---|
Speciality | Family Medicine |
Location | 1612 Nogales St, Rowland Heights, California |
Authorized Official Name and Position | Sunil Mahanama Dissanayake (PRESIDENT) |
Authorized Official Contact | 6269651646 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Sunil M. Dissanayake Md A Professional Corporation 1612 Nogales St Rowland Heights CA 91748-2257 Ph: (626) 965-1646 | Sunil M. Dissanayake Md A Professional Corporation 1612 Nogales St Rowland Heights CA 91748-2257 Ph: (626) 965-1646 |
NPI Number | 1811065204 |
---|---|
Provider Enumeration Date | 12/01/2006 |
Last Update Date | 05/14/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811065204 | NPI | - | NPPES |
00A394470 | Medicaid | CA | |
W20199 | Other | MEDICARE ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A39447 (California) | Primary |
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