T Sri MD a Professional Corp

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

A33938 Issued in CA

Legal business name

T SRI MD A PROFESSIONAL CORP

Practice address

9278 N Loop Blvd
California City, CA 93505-2236

Phone

(760) 373-4809

NPI assigned

Apr 16, 2007

Last updated

Oct 26, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Thillaiampalam Srijaerajah, M.D.

Title

President

Phone

(760) 373-4809

Specialties & licenses 1

Addresses

Other identifiers 2

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1568687317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44725 10TH ST W STE 230",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343048",
            "telephone_number": "661-948-1611",
            "fax_number": "661-945-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9278 N LOOP BLVD",
            "city": "CALIFORNIA CITY",
            "state": "CA",
            "postal_code": "935052236",
            "telephone_number": "760-373-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T SRI MD A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "SRIJAERAJAH",
        "authorized_official_first_name": "THILLAIAMPALAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-373-4809",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "A33938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0064251",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0064520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Legal Medicine in California City, CA
• Providers in California City, CA by specialty
• Legal Medicine in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.