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Organization
T SRI MD A PROFESSIONAL CORP
Active
Organization
T SRI MD A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THILLAIAMPALAM SRIJAERAJAH M.D. (PRESIDENT)
(760) 373-4809
Entity
Organization
Contact information
Practice address
9278 N LOOP BLVD, CALIFORNIA CITY, CA 93505-2236
(760) 373-4809
Mailing address
44725 10TH ST W STE 230, LANCASTER, CA 93534-3048
(661) 948-1611
(661) 945-5291
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
A33938
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0064251
—
CA
05
—
GR0064520
—
CA
Enumeration date
04/16/2007
Last updated
10/26/2010
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