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NPI Code Detail

MEDICARE: DR. MALATHY SRISKANDARAJAH M.D

MEDICARE: DR. MALATHY SRISKANDARAJAH M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA52549CA
2207R00000XInternal Medicine PhysicianA52549CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200A525490OTHERCABLUE SHIELD

General Provider Information

NPI Number : 1427066844
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MALATHY SRISKANDARAJAH M.D
Provider Business Mailing Address
First Line : 823 GATEWAY CENTER WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4541
Country : US
Telephone Number : 619-515-2300
Fax Number :
Provider Business Practice Location Address
First Line : 1250 6TH AVE STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92101-4368
Country : US
Telephone Number : 619-515-2430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 01/30/2023

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