Healthcare Provider Details

I. General information

NPI: 1922367382
Provider Name (Legal Business Name): KELLY ANN KAHARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 TECHNOLOGY DR
SAN JOSE CA
95110-1305
US

IV. Provider business mailing address

1721 TECHNOLOGY DR
SAN JOSE CA
95110-1305
US

V. Phone/Fax

Practice location:
  • Phone: 408-436-3300
  • Fax:
Mailing address:
  • Phone: 408-436-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA124260
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: