Provider Demographics
NPI:1124106646
Name:LANARK FAMILY MEDICAL CLINIC INC
Entity type:Organization
Organization Name:LANARK FAMILY MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITHA
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:KANKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-373-4870
Mailing Address - Street 1:8040 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-6010
Mailing Address - Country:US
Mailing Address - Phone:818-373-4870
Mailing Address - Fax:818-997-9442
Practice Address - Street 1:8040 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-6010
Practice Address - Country:US
Practice Address - Phone:818-373-4870
Practice Address - Fax:818-997-9442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0092260Medicaid