Provider Demographics
NPI:1962506469
Name:RATNAYAKE, SAMAN N (MD)
Entity Type:Individual
Prefix:MR
First Name:SAMAN
Middle Name:N
Last Name:RATNAYAKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8701 ANTIBES WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311
Mailing Address - Country:US
Mailing Address - Phone:661-323-3280
Mailing Address - Fax:661-323-3388
Practice Address - Street 1:6001-B TRUXTUN AVE
Practice Address - Street 2:STE 240
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-323-3280
Practice Address - Fax:661-323-3388
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56363207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A563631Medicaid
CA00A563630Medicare ID - Type Unspecified
CA00A563631Medicaid