Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Amila Vimara Nissanka, MD

Individual provider Family Medicine Physician · NPI 1073023594

Dr. Amila Vimara Nissanka, MD is an Emergency Medicine in Laguna Beach, California. Qualified in 2015, 11 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Alabama, Arizona, California and Illinois and 1 more.

Years since qualifying
11
Licensed in
AL, AZ, CA, IL, WI
In the registry since
2017
Specialties on file
7
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

303 Broadway St Ste 103
Laguna Beach, CA 92651-1816
Phone: (949) 665-6000
Fax: (949) 670-4967
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 20 Via Loma, Laguna Niguel, CA 92677-5148 — (949) 416-6267

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A174462 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 125071582 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 036.157093 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 74854-20 (WI)
Family Medicine Physician Taxonomy 207Q00000X · Licence 63792 (AZ)
Family Medicine Physician Taxonomy 207Q00000X · Licence 45836 (AL)
Surgery Physician Taxonomy 208600000X · Licence 125071582 (IL)

Record details

NPI number1073023594
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 10, 2017
Last updated in NPPESMay 4, 2023
Certification dateMay 4, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Also practisesFAMILY PRACTICE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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