Provider Demographics
NPI:1316932452
Name:KALAYTA, RONALD ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ARTHUR
Last Name:KALAYTA
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 1:901 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3323
Mailing Address - Country:US
Mailing Address - Phone:530-674-8170
Mailing Address - Fax:530-674-5728
Practice Address - Street 1:901 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3323
Practice Address - Country:US
Practice Address - Phone:530-674-8170
Practice Address - Fax:530-674-5728
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG22824207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G228240Medicaid
CA00G228240Medicare ID - Type Unspecified
CA00G228240Medicaid
CA0361700001Medicare NSC