Provider Demographics
NPI:1558701870
Name:SHARMA, ARUN KUMAR
Entity Type:Individual
Prefix:MR
First Name:ARUN
Middle Name:KUMAR
Last Name:SHARMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4732 PACIFIC PARK DR
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843-4326
Mailing Address - Country:US
Mailing Address - Phone:916-335-5122
Mailing Address - Fax:
Practice Address - Street 1:4732 PACIFIC PARK DR
Practice Address - Street 2:
Practice Address - City:ANTELOPE
Practice Address - State:CA
Practice Address - Zip Code:95843-4326
Practice Address - Country:US
Practice Address - Phone:916-335-5122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGNB32007-33281347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle