Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A46400 | CA |
N | 111NI0900X | Internist | A46400 | CA |
Y | 207RC0200X | Critical Care Medicine | A46400 | CA |
N | 207RP1001X | Pulmonary Disease | A46400 | CA |
N | 207RS0012X | Sleep Medicine | A46400 | CA |
NPI | 1083712236 |
---|---|
Provider Name | Dr. Errajith Bertrand Ricardo De Silva |
First Address | Riverside, CA 92501-3442 |
Second Address | Riverside, CA 92501-3442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 07/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A464000 | (05) | CA |
290008214 | MEDICARE RR (01) | CA |
409-444-7 | ECFMG (01) | |
BS1991036 | DEA NUMBER (01) | |
F14824 | (02) | CA |