Provider Demographics
NPI:1255411518
Name:KALE, ARUNDHATI (MD)
Entity type:Individual
Prefix:
First Name:ARUNDHATI
Middle Name:
Last Name:KALE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2208
Mailing Address - Country:US
Mailing Address - Phone:916-734-8118
Mailing Address - Fax:916-734-0629
Practice Address - Street 1:2516 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2208
Practice Address - Country:US
Practice Address - Phone:916-734-8118
Practice Address - Fax:916-734-0629
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ31272080P0210X
CAC1483832080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134072101Medicaid
TX8016N2Medicare PIN
F50746Medicare UPIN
TXTXB119017Medicare PIN
TX80377JMedicare PIN
TX8L0299Medicare PIN