Contact Us

2925 North Sycamore Drive

Suite 310

Simi Valley, California 93065

Phone (805) 527-2570

Fax (805) 527-2978

lakhanistaff@lakhani-cardiology.com

Office Hours:

Monday-Friday 8:30 a.m. - 5:00 p.m.

Saturday (appointment only)

Closed Sunday

Home Visits:

By appointment only, based on availability

Accepting most PPO insurance plans (please call our office to verify), as well as Medicare, cash, and credit card payments.

Staff admitting privileges at Los Robles Hospital (Thousand Oaks/Westlake Village, CA) and Simi Valley Hospital (Simi Valley, CA).

Second opinions and concierge services also available.

NEW PATIENTS: To expedite the scheduling of your appointment, please complete the form below. Our friendly staff will be in touch with you shortly.

NEW PATIENT INFORMATION

Full Name: Last, First, Middle Initial

Email:

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Date of Birth:

Gender:

Home Address: Number, Street Name, Apt/Unit #

City:

State:

Zip Code:

Work Address: Number, Street Name, Suite #

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Work Phone:

Preferred Contact For Leaving Message:

Type of PRIMARY Insurance Plan: HMO*, PPO, POS, Other

Health Plan:

IPA/Medical Group:

I.D. Number:

Group Number:

Policy Holder's Name:

Relationship to Patient: Self, Spouse, Parent, Other

Policy Holder's Date of Birth:

Type of SECONDARY Insurance Plan: HMO*, PPO, POS, Other

Health Plan:

IPA/Medical Group:

I.D. Number:

Group Number:

Policy Holder's Name:

Relationship to Patient: Self, Spouse, Parent, Other

Policy Holder's Date of Birth:

Message:

*HMO patients require a referral from their primary care physician for each visit. You must bring referral with you to your visits.

SITE DESIGN & DEVELOPMENT BY EYE ENGINE

2925 North Sycamore Drive, Suite 310

Simi Valley, CA 93065

T (805) 527-2570

F (805) 527-2978

Office Hours:

Monday - Friday

8:30 a.m. - 5:00 p.m.

Saturday (appointment only)

Closed Sunday

Home Visits:

By appointment only,

based on availability

We accept most PPO insurance plans

(please call our office to verify), Medicare, cash, and credit card payments