Provider Demographics
NPI:1992918312
Name:GUNARATNAM, MARTINA ROSHANI (MD)
Entity type:Individual
Prefix:DR
First Name:MARTINA
Middle Name:ROSHANI
Last Name:GUNARATNAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:349A E AVENUE K6
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-4548
Mailing Address - Country:US
Mailing Address - Phone:661-723-4260
Mailing Address - Fax:661-723-6925
Practice Address - Street 1:349A E AVENUE K6
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-4548
Practice Address - Country:US
Practice Address - Phone:617-234-2606
Practice Address - Fax:661-723-6925
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1240092084P0800X
HI193772084P0800X
IL390200000X
CAC1439722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program