Healthcare Provider Details

I. General information

NPI: 1750915971
Provider Name (Legal Business Name): RICHARD KHANAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

101 THE CITY DR S
ORANGE CA
92868-3201
US

V. Phone/Fax

Practice location:
  • Phone: 949-515-5210
  • Fax: 678-312-0439
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA201583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: