Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | A129389 | CA |
N | 207T00000X | Neurosurgeon | MD438027 | PA |
NPI | 1003033374 |
---|---|
Provider Name | Dr. Moksha Ranasinghe |
First Address | Montebello, CA 90640-4317 |
Second Address | Montebello, CA 90640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 06/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CB235128 | MEDICARE PTAN (01) | CA |