Individual
DR. CHANNA R JAYASEKERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MS, MSC
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5499
(408) 301-8000
(904) 953-0115
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5499
(408) 301-8000
(904) 953-0115
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A113689
CA
207RG0100X
Gastroenterology Physician
Primary
63158
AZ
207RG0100X
Gastroenterology Physician
A113689
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A113689
MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
10/19/2010
Last updated
04/19/2021
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