Healthcare Provider Details

I. General information

NPI: 1467847236
Provider Name (Legal Business Name): KANWARDEEP S KALEKA M.D., PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date: 02/25/2021
Reactivation Date: 04/07/2021

III. Provider practice location address

4463 PAHEE ST. STE. 206
LIHUE HI
96766
US

IV. Provider business mailing address

PO BOX 337
WAIMEA HI
96796-0337
US

V. Phone/Fax

Practice location:
  • Phone: 808-241-5799
  • Fax: 808-240-5583
Mailing address:
  • Phone: 808-240-2723
  • Fax: 808-240-5569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA147353
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA147353
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: