| 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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