Provider Demographics
NPI:1053494419
Name:DENG, SHARON (OMD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:DENG
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:924 BUENA VISTA ST
Mailing Address - Street 2:# 201
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-1779
Mailing Address - Country:US
Mailing Address - Phone:626-256-3341
Mailing Address - Fax:626-357-2528
Practice Address - Street 1:924 BUENA VISTA ST
Practice Address - Street 2:# 201
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-1779
Practice Address - Country:US
Practice Address - Phone:626-256-3341
Practice Address - Fax:626-357-2528
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5775171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist