Healthcare Provider Details

I. General information

NPI: 1891804803
Provider Name (Legal Business Name): VANESSA MARIA KALEB M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 ATLANTIC AVE STE. 250
LONG BEACH CA
90806-1740
US

IV. Provider business mailing address

2865 ATLANTIC AVE STE. 250
LONG BEACH CA
90806-1740
US

V. Phone/Fax

Practice location:
  • Phone: 562-595-7709
  • Fax: 562-595-5720
Mailing address:
  • Phone: 562-595-7709
  • Fax: 562-595-5720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberA71452
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: