# T SRI MD A PROFESSIONAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568687317
- **Authorized official:** DR. THILLAIAMPALAM SRIJAERAJAH M.D. (PRESIDENT)
- **Authorized official phone:** (760) 373-4809

## Contact information

- **Practice address:** 9278 N LOOP BLVD, CALIFORNIA CITY, CA 93505-2236
- **Practice address phone:** (760) 373-4809
- **Mailing address:** 44725 10TH ST W STE 230, LANCASTER, CA 93534-3048
- **Mailing address phone:** (661) 948-1611
- **Mailing address fax:** (661) 945-5291

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | A33938 | CA | Yes |

## Other

- **Enumeration date:** 04/16/2007
- **Last updated:** 10/26/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0064251 | — | CA |
| 05 | — | GR0064520 | — | CA |