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Organization
SARATH C WITANA MEDICAL GROUP INC
Active
Organization
SARATH C WITANA MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARATH C WITANA MD (MEDICAL DOCTOR)
(951) 243-6460
Entity
Organization
Contact information
Practice address
24060 FIR AVE, SUITE A, MORENO VALLEY, CA 92553-2895
(951) 243-6460
(951) 243-5871
Mailing address
24060 FIR AVE, SUITE A, MORENO VALLEY, CA 92553-2895
(951) 243-6460
(951) 243-5871
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A50338
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A503380
—
CA
Enumeration date
08/31/2006
Last updated
03/08/2011
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