Provider Demographics
NPI:1407806375
Name:SHARMA, KARUNA (MD)
Entity Type:Individual
Prefix:DR
First Name:KARUNA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:ATTN CREDENTIALING/PAYER ENROLLMENT
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1820 41ST AVE STE C
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2516
Practice Address - Country:US
Practice Address - Phone:831-684-7611
Practice Address - Fax:831-477-2009
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01047963A207P00000X
CAC140562207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01047963AOtherINDIANA MEDICAL LICENSING
INBS5329796OtherDEA
IN01047963BOtherINDIANA CSR
IN01047963BOtherINDIANA CSR
INBS5329796OtherDEA
IN01047963AOtherINDIANA MEDICAL LICENSING
OH4255196Medicare PIN