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Individual

DR. IRESHA C GOONESINGHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
301 DRUMMOND AVE, RIDGECREST, CA 93555-3187
(760) 371-3008
(760) 371-3009
Mailing address
PO BOX 340457, SACRAMENTO, CA 95834-0457
(760) 383-3040

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A061625
CA
207RC0000X
Cardiovascular Disease Physician
Primary
A061625
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
770569362
TAX ID
CA
Enumeration date
09/09/2005
Last updated
02/17/2022
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