Healthcare Provider Details

I. General information

NPI: 1902020571
Provider Name (Legal Business Name): VIRENDER S. KALEKA, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N. CLARK ST, SUITE A
FRESNO CA
93701-2124
US

IV. Provider business mailing address

2057 HIGH ST
SELMA CA
93662-3512
US

V. Phone/Fax

Practice location:
  • Phone: 559-264-0565
  • Fax: 559-264-0567
Mailing address:
  • Phone: 559-897-5399
  • Fax: 559-897-9670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberA43546
License Number StateCA

VIII. Authorized Official

Name: MRS. LYNNE C. WARFORD
Title or Position: OFFICE MANAGER
Credential:
Phone: 559-897-5399