Healthcare Provider Details

I. General information

NPI: 1346298924
Provider Name (Legal Business Name): GURJEET S KALKAT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 E GLADSTONE ST
GLENDORA CA
91740-5159
US

IV. Provider business mailing address

651 VALPARAISO DR
CLAREMONT CA
91711-1583
US

V. Phone/Fax

Practice location:
  • Phone: 626-963-5955
  • Fax: 951-430-3367
Mailing address:
  • Phone: 951-334-9516
  • Fax: 951-430-3367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA46604
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: