Provider Demographics
NPI:1346298924
Name:KALKAT, GURJEET S (MD)
Entity Type:Individual
Prefix:DR
First Name:GURJEET
Middle Name:S
Last Name:KALKAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 VALPARAISO DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1583
Mailing Address - Country:US
Mailing Address - Phone:951-334-9516
Mailing Address - Fax:951-430-3367
Practice Address - Street 1:435 E GLADSTONE ST
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-5159
Practice Address - Country:US
Practice Address - Phone:626-963-5955
Practice Address - Fax:951-430-3367
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46604174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA76759Medicare UPIN