Most Relevant Information
Provider Data
| NPI Number: | 1003494766 |
| Provider Name: | ISHANI D PREMARATNE MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/01/2021 |
| Last Updated: | 04/01/2021 |
Provider Practice Location
1200 N STATE ST STE A7D
LOS ANGELES
CA
900891001
Practice Location Phone/Fax
| Phone: | 3234096225 |
| Fax: |
Provider Mailing Location
1200 N STATE ST STE A7D
LOS ANGELES
CA
900891001
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |