Provider Demographics
NPI:1174840680
Name:WICKRAMASINGHE, CHANAKA DINESHA (MD)
Entity Type:Individual
Prefix:
First Name:CHANAKA
Middle Name:DINESHA
Last Name:WICKRAMASINGHE
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:39000 BOB HOPE DRIVE
Mailing Address - Street 2:HAL B. WALLIS BLDG
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-346-0642
Mailing Address - Fax:760-340-9142
Practice Address - Street 1:39000 BOB HOPE DRIVE
Practice Address - Street 2:HAL B. WALLIS BLDG
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-346-0642
Practice Address - Fax:760-340-9142
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA130331207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease