Basic Information
| Provider Information | |||||||||
| NPI: | 1366548646 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COORAY | ||||||||
| FirstName: | DILRUKSHIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CORNELIO | ||||||||
| OtherFirstName: | DILRUKSHIE | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 21840 NORMANDIE AVE | ||||||||
| Address2: | STE. 700 | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102225101 | ||||||||
| FaxNumber: | 3103205463 | ||||||||
| Practice Location | |||||||||
| Address1: | 21840 NORMANDIE AVE | ||||||||
| Address2: | STE. 700 | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102225101 | ||||||||
| FaxNumber: | 3103205463 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 02/09/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | A80659 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.