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General NPI Number Information
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NPI Number | 1376451807
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Entity Type | Organization
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Legal Business Name | KALLE STIDHAM D.O. INC
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 125 N JACKSON AVE STE 205
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City | SAN JOSE
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State | CA
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Zip | 95116-1915
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Country | US
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Telephone | 408-929-5610
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Fax |
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Provider Business Mailing Address
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Address Line | 125 N JACKSON AVE STE 205
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City | SAN JOSE
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State | CA
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Zip | 95116-1915
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Country | US
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Telephone | 408-258-6565
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Fax |
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Authorized Official
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Title or Position | ORTHOPEDIC SURGEON
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Name | DR. KALLE STIDHAM
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Credential | DO
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Telephone | 650-319-5771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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