Healthcare Provider Details
I. General information
NPI: 1124106646
Provider Name (Legal Business Name): LANARK FAMILY MEDICAL CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8040 VAN NUYS BLVD
PANORAMA CITY CA
91402-6010
US
IV. Provider business mailing address
8040 VAN NUYS BLVD
PANORAMA CITY CA
91402-6010
US
V. Phone/Fax
- Phone: 818-373-4870
- Fax: 818-997-9442
- Phone: 818-373-4870
- Fax: 818-997-9442
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
ANITHA
REDDY
KANKAR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-373-4870