Healthcare Provider Details

I. General information

NPI: 1053567339
Provider Name (Legal Business Name): ISHAAN S. KALHA, MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 04/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 MOUNT VERNON AVE SUITE 108
BAKERSFIELD CA
93306-3341
US

IV. Provider business mailing address

PO BOX 2172
BAKERSFIELD CA
93303-2172
US

V. Phone/Fax

Practice location:
  • Phone: 661-872-3311
  • Fax: 661-872-3366
Mailing address:
  • Phone: 661-281-2125
  • Fax: 661-281-2126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA72491
License Number StateCA

VIII. Authorized Official

Name: DR. ISHAAN S KALHA
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 661-872-3311