Provider Demographics
NPI:1508966508
Name:SHARMA, SAMIR (MD)
Entity Type:Individual
Prefix:
First Name:SAMIR
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2237 QUAIL BLUFF CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-3210
Mailing Address - Country:US
Mailing Address - Phone:530-294-1136
Mailing Address - Fax:530-294-1143
Practice Address - Street 1:14651 S BASCOM AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2014
Practice Address - Country:US
Practice Address - Phone:408-356-9422
Practice Address - Fax:408-356-9042
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA27947207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH27947Medicare UPIN