Provider Demographics
NPI:1417454844
Name:LANI CITY MEDICAL
Entity type:Organization
Organization Name:LANI CITY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHEMLANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-727-3911
Mailing Address - Street 1:14071 PEYTON DR UNIT 2456
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-7209
Mailing Address - Country:US
Mailing Address - Phone:909-727-3911
Mailing Address - Fax:
Practice Address - Street 1:11398 KENYON WAY STE J
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91701-9229
Practice Address - Country:US
Practice Address - Phone:909-727-3911
Practice Address - Fax:909-727-3925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care