Healthcare Provider Details

I. General information

NPI: 1144334228
Provider Name (Legal Business Name): D LALANI PERERA-THANGARATNAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W LA PALMA AVE
ANAHEIM CA
92801-2804
US

IV. Provider business mailing address

5 HOLLAND STE 101
IRVINE CA
92618-2568
US

V. Phone/Fax

Practice location:
  • Phone: 714-774-1450
  • Fax:
Mailing address:
  • Phone: 949-588-2190
  • Fax: 949-588-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA70242
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: