Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. AMILA VIMARA NISSANKA, MD
ActiveDR. AMILA VIMARA NISSANKA, MD is a Family Medicine healthcare provider located in LAGUNA BEACH, California. NPI 1073023594 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · LAGUNA BEACH, CA
Registration Details
- NPI Number
- 1073023594
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 10, 2017 (8.857719461649 yrs)
- Last Updated
- May 4, 2023
- Licenses
-
125071582 (IL)036.157093 (IL)74854-20 (WI)63792 (AZ)45836 (AL)
Practice Information
- Address
-
303 BROADWAY ST STE 103LAGUNA BEACH, CA, 926511816Browse CA providers · Browse ZIP 92651
- Phone
- 9496656000
- Fax
- 9496704967
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
- Additional Specialty
- Family Medicine
- Additional Specialty
- Family Medicine
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in LAGUNA BEACH, CA
| Name | Credential | NPI |
|---|---|---|
| DR. KOREY STEPHEN JORGENSEN | M.D. | 1053349795 |
| DR. EDWARD L SMITH | D.O. | 1538188206 |
| DR. WILLIAM CARL ANDERSON | MD | 1811093982 |
| DR. KEYS S KEEL | MD | 1508964453 |
| MRS. ROBIN ANN ECKERT | MD | 1720187834 |
| ROBERT JAMES FRENCH | MD | 1538260617 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.