De Silva, Keerthi R

De Silva, Keerthi R is an sole proprietor health care provider with primary practice located at 1141 W Redondo Beach Blvd Suite 107, Gardena CA 90247-3586. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. De Silva, Keerthi R can be contacted via phone (310) 515-0677.

Contact Information

Primary practice address
1141 W Redondo Beach Blvd Suite 107 Gardena CA 90247-3586
Fax: (310) 515-5033
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A30035 California

Profile Details

NPI number 1457359291
LBN Legal business name De Silva, Keerthi R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 13th, 2005
Last updated Mar 28th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457359291 NPPES
California MEDICAID 00A300350

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