Provider Demographics
NPI:1952460248
Name:KHANAL, SANJAYA (MD)
Entity Type:Individual
Prefix:
First Name:SANJAYA
Middle Name:
Last Name:KHANAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43723 20TH ST W STE 101
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4784
Mailing Address - Country:US
Mailing Address - Phone:661-674-4222
Mailing Address - Fax:661-674-4211
Practice Address - Street 1:43807 N 10TH ST WEST
Practice Address - Street 2:SUITE F
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-940-0535
Practice Address - Fax:661-940-0537
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA054074207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
G98387Medicare UPIN