Organization
SERENDIB HEALTHWAYS, INC
Active
Other names
SERENDIB HEALTHWAYS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANESRI W DE SILVA M.D. (PRESIDENT)
(818) 305-3755
Entity
Organization
Contact information
Practice address
14608 VICTORY BLVD, VAN NUYS, CA 91411-1621
(818) 786-7710
(818) 786-7711
Mailing address
18543 DEVONSHIRE ST, SUITE 435, NORTHRIDGE, CA 91324-1308
(818) 786-7710
(818) 786-7711
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
A889910
CA
208D00000X
General Practice Physician
Primary
A889910
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A889910
MEDICAL LICENSE
CA
Enumeration date
05/26/2012
Last updated
05/26/2012
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