Provider Demographics
NPI:1235192220
Name:SHARMA, RAHUL (MD)
Entity Type:Individual
Prefix:
First Name:RAHUL
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9610 STOCKDALE HWY UNIT B
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3626
Mailing Address - Country:US
Mailing Address - Phone:616-664-0314
Mailing Address - Fax:616-664-0997
Practice Address - Street 1:9610 STOCKDALE HWY UNIT B
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3626
Practice Address - Country:US
Practice Address - Phone:661-664-0997
Practice Address - Fax:661-664-0997
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72532207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A725320Medicaid
CA1851643241Medicaid
CAA72532OtherSTATE LICENSE
CAH58978Medicare UPIN