Organization
JANESRI DE SILVA M.D. A PROF CORP
Active
Other names
KIDS& TEENS MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANESRI WIJAYANGANI DE SILVA M.D. (PRESIDENT)
(818) 361-5437
Entity
Organization
Contact information
Practice address
10550 SEPULVEDA BLVD, SUITE 101, MISSION HILLS, CA 91345-1934
(818) 361-5437
(818) 361-5695
Mailing address
18543 DEVONSHIRE ST STE 430, NORTHRIDGE, CA 91324-1308
(818) 361-5437
(818) 361-5695
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A88991
CA
2080A0000X
Pediatric Adolescent Medicine Physician
A88991
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A889910
—
CA
Enumeration date
08/27/2009
Last updated
08/27/2009
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