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General NPI Number Information
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NPI Number | 1730100330
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Entity Type | Individual
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Provider Name | UDAYA DESILVA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 05/14/2021
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Provider Practice Location Address
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Address Line | 623 W AVENUE Q SUITE A
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City | PALMDALE
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State | CA
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Zip | 93551-3890
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Country | US
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Telephone | 661-726-6255
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Fax | 661-726-6261
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Provider Business Mailing Address
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Address Line | PO BOX 4037
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City | LANCASTER
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State | CA
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Zip | 93539-4037
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Country | US
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Telephone | 661-726-6255
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Fax | 661-726-6261
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | A48836
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License Number State | CA
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