MEDICARE: DR. CHAND KHANNA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	A35189	CA

General Provider Information

NPI Number	:	1699776302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAND KHANNA M.D.

Provider Business Mailing Address
First Line	:	24500 BRECKENRIDGE PL
Second Line	:
City	:	NEWHALL
State	:	CA
Zip	:	91321-2607
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23928 LYONS AVE
Second Line	:	SUITE 203
City	:	NEWHALL
State	:	CA
Zip	:	91321-2409
Country	:	US
Telephone Number	:	661-254-7216
Fax Number	:	661-254-4830

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	08/02/2016

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