Healthcare Provider Details

I. General information

NPI: 1497602999
Provider Name (Legal Business Name): HARSHA DILAN PERERA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SAN PABLO ST
LOS ANGELES CA
90033-5313
US

IV. Provider business mailing address

262 N LOS ROBLES AVE APT 225
PASADENA CA
91101-1507
US

V. Phone/Fax

Practice location:
  • Phone: 800-872-2273
  • Fax:
Mailing address:
  • Phone: 718-759-7531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95002882
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95195277
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: