Provider Demographics
NPI:1043594047
Name:PABLA, SHARON (PA-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:PABLA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2573 PACIFIC COAST HWY STE B
Mailing Address - Street 2:PACIFIC COAST HIGHWAY
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-7950
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2573 PACIFIC COAST HWY STE B
Practice Address - Street 2:PACIFIC COAST HIGHWAY
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-7950
Practice Address - Country:US
Practice Address - Phone:310-997-1798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA21880363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical