Provider Demographics
NPI:1902020571
Name:VIRENDER S. KALEKA, M.D.
Entity Type:Organization
Organization Name:VIRENDER S. KALEKA, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:WARFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-897-5399
Mailing Address - Street 1:2057 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-3512
Mailing Address - Country:US
Mailing Address - Phone:559-897-5399
Mailing Address - Fax:559-897-9670
Practice Address - Street 1:141 N. CLARK ST,
Practice Address - Street 2:SUITE A
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2124
Practice Address - Country:US
Practice Address - Phone:559-264-0565
Practice Address - Fax:559-264-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43546261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1982659322OtherPROVIDER NPI
CA00A435461Medicaid
CA00A435461Medicare PIN
CA1982659322OtherPROVIDER NPI