Healthcare Provider Details

I. General information

NPI: 1467915082
Provider Name (Legal Business Name): HOLUPATHIRAGE KALHARA CALDERA MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 E SPRUCE AVE STE 201
FRESNO CA
93720-3313
US

IV. Provider business mailing address

1111 E SPRUCE AVE STE 431
FRESNO CA
93720-3330
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-2630
  • Fax: 559-450-0351
Mailing address:
  • Phone: 559-450-7449
  • Fax: 559-450-7470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA179254
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberA179254
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: