Healthcare Provider Details
I. General information
NPI: 1538089727
Provider Name (Legal Business Name): LANI CITY MEDICAL RIVERSIDE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2915 VAN BUREN BLVD STE J1
RIVERSIDE CA
92503-5693
US
IV. Provider business mailing address
PO BOX 2456
CHINO HILLS CA
91709-0082
US
V. Phone/Fax
- Phone: 909-727-3911
- Fax: 909-727-3925
- Phone: 909-727-3911
- Fax: 909-727-3925
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUNIEL
KHEMLANI
Title or Position: PRESIDENT
Credential: MD
Phone: 909-727-3911