Healthcare Provider Details

I. General information

NPI: 1568685386
Provider Name (Legal Business Name): VIRENDER S. KALEKA, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12572 AVENUE 416 SUITE B
OROSI CA
93647-2067
US

IV. Provider business mailing address

2057 HIGH ST
SELMA CA
93662-3512
US

V. Phone/Fax

Practice location:
  • Phone: 559-528-4779
  • Fax: 559-528-3349
Mailing address:
  • Phone: 559-897-5399
  • Fax: 559-897-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberA43546
License Number StateCA

VIII. Authorized Official

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