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JANESRI DE SILVA M.D. A PROF CORP NPI 1548493315


NPI Information

NPI: 1548493315
Provider Name: JANESRI DE SILVA M.D. A PROF CORP

Doing Business As: KIDS& TEENS MEDICAL GROUP

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D1056493

Address:
10550 SEPULVEDA BLVD
SUITE 101
MISSION HILLS, CA
ZIP 91345
Phone: (818) 361-5437
Get Directions

JANESRI DE SILVA M.D. A PROF CORP is a pediatrics in Mission Hills, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. JANESRI DE SILVA M.D. A PROF CORP NPI is 1548493315. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Kids& Teens Medical Group.

The provider's business location address is:

10550 SEPULVEDA BLVD
SUITE 101
MISSION HILLS, CA
ZIP 91345-934
Phone: (818) 361-5437
Fax: (818) 361-5695

The provider's authorized official is Janesri Wijayangani De Silva .
The authorized official title is President and has the following contact phone number (818) 361-5437.

The CLIA number assigned to this NPI record is 05D1056493 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/27/2009 and was last updated on 8/27/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080A0000XPediatricsAdolescent MedicineA88991CALIFORNIANo
2208000000XPediatricsA88991CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100A889910MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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