MEDICARE: DR. THILLAIAMPALAM SRIJAERAJAH MD

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
1	207R00000X	Internal Medicine Physician	A33938	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1538271002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THILLAIAMPALAM SRIJAERAJAH MD

Provider Business Mailing Address
First Line	:	44725 10TH ST W
Second Line	:	230
City	:	LANCASTER
State	:	CA
Zip	:	93534
Country	:	US
Telephone Number	:	661-948-1611
Fax Number	:	661-945-5291

Provider Business Practice Location Address
First Line	:	9278 N LOOP BLVD
Second Line	:
City	:	CALIFORNIA CITY
State	:	CA
Zip	:	93505-2236
Country	:	US
Telephone Number	:	760-373-4809
Fax Number	:	760-373-4800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	10/26/2010

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