Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A163828 | CA |
Y | 111NI0900X | Internist | A163828 | CA |
NPI | 1003343799 |
---|---|
Provider Name | Sevwandi De Silva |
First Address | Loma Linda, CA 92354-2804 |
Second Address | Rancho Mirage, CA 92270-3221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2017 |
Last Update Date | 08/11/2021 |