Provider Demographics
NPI:1235120890
Name:JAYASINGHE, GAMINI (MD)
Entity Type:Individual
Prefix:DR
First Name:GAMINI
Middle Name:
Last Name:JAYASINGHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8522 TRAVISTUCK PL
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1602
Mailing Address - Country:US
Mailing Address - Phone:714-523-8191
Mailing Address - Fax:714-899-4275
Practice Address - Street 1:8522 TRAVISTUCK PL
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-1602
Practice Address - Country:US
Practice Address - Phone:714-523-8191
Practice Address - Fax:714-899-4275
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA266142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26614AMedicare ID - Type Unspecified
CAA24903Medicare UPIN