| Gimha S Gunawardana M D Inc | |
|
255 E Bonita Ave #101 Pomona CA 91767-1923 | |
| (909) 524-1940 | |
| (909) 524-1943 |
| Full Name | Gimha S Gunawardana M D Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 255 E Bonita Ave, Pomona, California |
| Authorized Official Name and Position | Gimha Sudhani Gunawardana (PRESIDENT) |
| Authorized Official Contact | 9099651215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gimha S Gunawardana M D Inc 999 San Bernardino Rd Upland CA 91786-4920 Ph: (909) 985-2811 | Gimha S Gunawardana M D Inc 255 E Bonita Ave #101 Pomona CA 91767-1923 Ph: (909) 524-1940 |
| NPI Number | 1700257789 |
|---|---|
| Provider Enumeration Date | 10/15/2015 |
| Last Update Date | 05/03/2024 |
| Medicare PECOS PAC ID | 7810290780 |
|---|---|
| Medicare Enrollment ID | O20160127000739 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700257789 | NPI | - | NPPES |
| 1720274921 | Other | CA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | A101531 (California) | Primary |
| Provider Name | Gimha S Gunawardana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720274921 PECOS PAC ID: 6103971965 Enrollment ID: I20090831000143 |
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