MEDICARE: DR. GEORGE M JAYATILAKA 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
1	208D00000X	General Practice Physician	A26403	CA

General Provider Information

NPI Number	:	1841361334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE M JAYATILAKA M.D.

Provider Business Mailing Address
First Line	:	1045 ATLANTIC AVE STE 818
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-3410
Country	:	US
Telephone Number	:	562-436-8117
Fax Number	:	562-432-2777

Provider Business Practice Location Address
First Line	:	1045 ATLANTIC AVE STE 818
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-3410
Country	:	US
Telephone Number	:	562-436-8117
Fax Number	:	562-432-2777

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	02/21/2025

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