Provider Demographics
NPI:1568991990
Name:KALEKA, KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:KALEKA
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 1:2057 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:559-449-1237
Mailing Address - Fax:559-449-1340
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?:No
Enumeration Date:2017-06-08
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA164006207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1548920788Medicaid
CA1306506530Medicaid
CA1467112607Medicaid
CA1922768159Medicaid
CA1265192512Medicaid