Provider Demographics
NPI:1982659322
Name:KALEKA, VIRENDER SINGH (MD)
Entity Type:Individual
Prefix:
First Name:VIRENDER
Middle Name:SINGH
Last Name:KALEKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:VIRENDER
Other - Middle Name:S
Other - Last Name:KALEKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
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:559-891-9100
Mailing Address - Fax:559-891-7827
Practice Address - Street 1:2057 HIGH ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-3512
Practice Address - Country:US
Practice Address - Phone:559-891-9100
Practice Address - Fax:559-891-7827
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43546208D00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA553935OtherMEDICARE PROVIDER NUMBER
CA553946OtherMEDICARE PROVIDER NUMBER
CARHM53946FMedicaid
CAA43546OtherCA MEDICAL LICENSE
CARHM53946FMedicaid