Provider Demographics
NPI:1114553112
Name:SHARAF MD
Entity Type:Organization
Organization Name:SHARAF MD
Other - Org Name:ORANGE COUNTY CARDIOVASCULAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDULKAREEM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-912-0047
Mailing Address - Street 1:11100 WARNER AVE STE 354
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7513
Mailing Address - Country:US
Mailing Address - Phone:714-912-0047
Mailing Address - Fax:714-912-0087
Practice Address - Street 1:11100 WARNER AVE STE 354
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7513
Practice Address - Country:US
Practice Address - Phone:714-912-0047
Practice Address - Fax:714-912-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-21
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA160053Medicaid