Physician Compare National (NPI:1720274921)

HEALTHCARE PROVIDER: GIMHA SUDHANI GUNAWARDANA M.D

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1720274921
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6103971965
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090831000143
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GUNAWARDANA
	Individual professional last name
Provider First Name	GIMHA
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	HOSPICE/PALLIATIVE CARE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC MEDICINE, HOSPICE/PALLIATIVE CARE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	999 SAN BERNARDINO RD
	Group Practice or individual's line 1 address
City	UPLAND
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	917864920
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050099
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAN ANTONIO REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050782
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CASA COLINA HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y