Provider Demographics
NPI:1114004041
Name:SENEVIRATNA, SWARNAPALI RP (MD)
Entity Type:Individual
Prefix:
First Name:SWARNAPALI
Middle Name:RP
Last Name:SENEVIRATNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 MIRAMONTE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2457
Mailing Address - Country:US
Mailing Address - Phone:650-965-3323
Mailing Address - Fax:
Practice Address - Street 1:900 MIRAMONTE AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2457
Practice Address - Country:US
Practice Address - Phone:650-965-3323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53383208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A533830Medicaid
G70443Medicare UPIN
CA00A533830Medicaid