Organization
EMPIRE SPECIALISTS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER JAYASINGHE M.D. (CEO)
(951) 280-7700
Entity
Organization
Contact information
Practice address
82013 DR CARREON BLVD, SUITE G, INDIO, CA 92201-4832
(951) 280-7888
(951) 372-9014
Mailing address
2115 COMPTON AVE, SUITE 104, CORONA, CA 92881-7272
(626) 798-8600
(626) 798-8842
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
01/27/2011
Last updated
11/26/2012
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