Basic Information
| Provider Information | |||||||||
| NPI: | 1396023032 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIDHU | ||||||||
| FirstName: | JASPREET | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2488 N CALIFORNIA ST | ||||||||
| Address2: | |||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952045508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2099483333 | ||||||||
| FaxNumber: | 2099482665 | ||||||||
| Practice Location | |||||||||
| Address1: | 2488 N CALIFORNIA ST | ||||||||
| Address2: | |||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2099483333 | ||||||||
| FaxNumber: | 2099482665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2011 | ||||||||
| LastUpdateDate: | 06/20/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 60579 | MN | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | OT014143 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0801X | 60579 | MN | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma | 207X00000X | 20A15530 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.