Provider Demographics
NPI:1427228873
Name:RATNAYAKE, ANOSHIE R (MD)
Entity type:Individual
Prefix:
First Name:ANOSHIE
Middle Name:R
Last Name:RATNAYAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 MARENGO ST
Mailing Address - Street 2:ROOM 1G-1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1365
Mailing Address - Country:US
Mailing Address - Phone:323-226-3813
Mailing Address - Fax:
Practice Address - Street 1:1801 MARENGO ST
Practice Address - Street 2:ROOM 1G-1
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1365
Practice Address - Country:US
Practice Address - Phone:323-226-3813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-01
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87525207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology