Healthcare Provider Details

I. General information

NPI: 1669211546
Provider Name (Legal Business Name): KIRANDEEP KAUR KALER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 E 6TH ST
MADERA CA
93638-3631
US

IV. Provider business mailing address

5050 W GARLAND AVE
FRESNO CA
93722-7164
US

V. Phone/Fax

Practice location:
  • Phone: 559-664-4000
  • Fax: 559-479-4812
Mailing address:
  • Phone: 559-540-5038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95029484
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: