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NPI Code Detail

MEDICARE: DR. DASUNI PAMODA THATHSARANI RATHNAYAKE MD

MEDICARE: DR. DASUNI PAMODA THATHSARANI RATHNAYAKE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianDR.0069447CO

General Provider Information

NPI Number : 1730649898
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DASUNI PAMODA THATHSARANI RATHNAYAKE MD
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number : 702-579-3203
Fax Number :
Provider Business Practice Location Address
First Line : 2610 TENDERFOOT HILL ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-3981
Country : US
Telephone Number : 719-522-1133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2019
Last Update Date : 04/15/2026

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