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Organization
MIHIRI DESILVA-KLEBICKI, D.O., APC
Active
Organization
MIHIRI DESILVA-KLEBICKI, D.O., APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIHIRI DESILVA-KLEBICKI D.O. (DIRECT OWNER)
(818) 888-7815
Entity
Organization
Contact information
Practice address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
(818) 782-6600
(818) 715-1722
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20A9248
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
20A9248
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00AX92480
BLUE SHIELD OF CA
CA
01
—
W20A9248A
MEDICARE PPIN
CA
Enumeration date
04/11/2006
Last updated
09/11/2007
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