Organization
SOUTHERN CALIFORNIA BRAIN & SPINE SURGERY
Active
Organization
SOUTHERN CALIFORNIA BRAIN & SPINE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOKSHA GANDHARI RANASINGHE M.D. (PRESIDENT)
(213) 369-4583
Entity
Organization
Contact information
Practice address
101 E BEVERLY BLVD STE 404A, MONTEBELLO, CA 90640
(213) 369-4583
(866) 876-7956
Mailing address
101 E BEVERLY BLVD STE 404A, MONTEBELLO, CA 90640-4317
(213) 369-4583
(866) 876-7956
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB235126
MEDICARE PTAN
CA
Enumeration date
05/08/2015
Last updated
05/20/2019
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