| Kanishka Wijegunaratne, Md Inc | |
|
5901 W Olympic Blvd Ste 504 Los Angeles CA 90036-4633 | |
| (310) 477-8400 | |
| Not Available |
| Full Name | Kanishka Wijegunaratne, Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5901 W Olympic Blvd Ste 504, Los Angeles, California |
| Authorized Official Name and Position | Kanishka Wijegunaratne (PRESIDENT) |
| Authorized Official Contact | 7149289927 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kanishka Wijegunaratne, Md Inc 16837 Shileno Pl Encino CA 91436-3534 Ph: (714) 928-9927 | Kanishka Wijegunaratne, Md Inc 5901 W Olympic Blvd Ste 504 Los Angeles CA 90036-4633 Ph: (310) 477-8400 |
| NPI Number | 1639783194 |
|---|---|
| Provider Enumeration Date | 09/02/2020 |
| Last Update Date | 09/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639783194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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