Healthcare Provider Details

I. General information

NPI: 1275251563
Provider Name (Legal Business Name): PRANEET K KALKAT MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 E GREEN ST STE 105
PASADENA CA
91106-2443
US

IV. Provider business mailing address

PO BOX 1449
BREA CA
92822-1449
US

V. Phone/Fax

Practice location:
  • Phone: 626-304-0782
  • Fax: 626-310-0552
Mailing address:
  • Phone: 714-996-1633
  • Fax: 714-996-9267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: PRANEET K KALKAT
Title or Position: CEO/OWNER
Credential: MD
Phone: 909-908-5294