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General NPI Number Information
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NPI Number | 1053548644
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Entity Type | Individual
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Provider Name | SUNIEL S. KHEMLANI MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2009
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 11398 KENYON WAY STE J
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-9229
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Country | US
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Telephone | 818-620-6193
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Fax |
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Provider Business Mailing Address
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Address Line | 14071 PEYTON DR UNIT 2456
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City | CHINO HILLS
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State | CA
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Zip | 91709-7209
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Country | US
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Telephone | 818-620-6193
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A121065
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License Number State | CA
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