Basic Information
| Provider Information | |||||||||
| NPI: | 1952460248 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KHANAL | ||||||||
| FirstName: | SANJAYA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43723 20TH ST W STE 101 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935344784 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6616744222 | ||||||||
| FaxNumber: | 6616744211 | ||||||||
| Practice Location | |||||||||
| Address1: | 43807 N 10TH ST WEST | ||||||||
| Address2: | SUITE F | ||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6619400535 | ||||||||
| FaxNumber: | 6619400537 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 03/13/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | A054074 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.