Provider Demographics
NPI:1578744496
Name:SHARON F. BILLON, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SHARON F. BILLON, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:F
Authorized Official - Last Name:BILLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-481-5100
Mailing Address - Street 1:207 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-3311
Mailing Address - Country:US
Mailing Address - Phone:805-481-5100
Mailing Address - Fax:
Practice Address - Street 1:207 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-3311
Practice Address - Country:US
Practice Address - Phone:805-481-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30339207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G303390Medicaid
CAA44386Medicare UPIN
CAG30339Medicare PIN