Sunil M. Dissanayake MD a Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A39447 Issued in CA

Legal business name

SUNIL M. DISSANAYAKE MD A PROFESSIONAL CORPORATION

Practice address

1612 Nogales St
Rowland Heights, CA 91748-2257

Phone

(626) 965-1646

Fax

(626) 965-4697

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Sunil Mahanama Dissanayake, M.D.

Title

President

Phone

(626) 965-1646

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1811065204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 NOGALES ST",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917482257",
            "telephone_number": "626-965-1646",
            "fax_number": "626-965-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 NOGALES ST",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917482257",
            "telephone_number": "626-965-1646",
            "fax_number": "626-965-4697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNIL M. DISSANAYAKE MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "DISSANAYAKE",
        "authorized_official_first_name": "SUNIL",
        "authorized_official_middle_name": "MAHANAMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-965-1646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A39447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A394470",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "W20199",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Suarez
• Laihah Suen, RPH
• Peter Sun, L.AC.
• Tina Feng-Pei Sun, DDS
• Sung Koo Kim,DDS,Inc.
• Sunkan Corp.
• Sunkan,LLC
• Anais Sustayta
• Maximus Sweeney
• Symphoneats

• Family Medicine Physician in Rowland Heights, CA
• Providers in Rowland Heights, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.