Provider Demographics
NPI:1295024081
Name:KALDAS, KIRSTEN ASHLEY (DO)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:ASHLEY
Last Name:KALDAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-1949
Mailing Address - Country:US
Mailing Address - Phone:818-627-3050
Mailing Address - Fax:818-627-3052
Practice Address - Street 1:7515 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-1949
Practice Address - Country:US
Practice Address - Phone:818-947-4026
Practice Address - Fax:818-779-7953
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine