Healthcare Provider Details

I. General information

NPI: 1730282286
Provider Name (Legal Business Name): WALTER JAYASINGHE MD APAC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 WILSHIRE BLVD SECOND FLOOR
LOS ANGELES CA
90057-3507
US

IV. Provider business mailing address

1930 WILSHIRE BLVD SUITE 1100
LOS ANGELES CA
90057-3605
US

V. Phone/Fax

Practice location:
  • Phone: 213-483-9209
  • Fax: 213-483-0250
Mailing address:
  • Phone: 213-483-2620
  • Fax: 213-483-7918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA38978
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA13399
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA26210
License Number StateCA

VIII. Authorized Official

Name: DR. WALTER JAYASINGHE
Title or Position: OWNER
Credential: M.D.
Phone: 213-483-2620