Basic Information
| Provider Information | |||||||||
| NPI: | 1316216831 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANJAYA KHANAL, M.D., INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2030 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935392030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616744222 | ||||||||
| FaxNumber: | 6616744220 | ||||||||
| Practice Location | |||||||||
| Address1: | 43723 20TH ST W | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935344784 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616744222 | ||||||||
| FaxNumber: | 6616744220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2011 | ||||||||
| LastUpdateDate: | 06/11/2012 | ||||||||
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| AuthorizedOfficialLastName: | KHANAL | ||||||||
| AuthorizedOfficialFirstName: | SANJAYA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6617269500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | A54074 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207R00000X | A54074 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.