Provider Demographics
NPI:1598724080
Name:SHARMA, KANIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:KANIKA
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 1:4200 PARK BLVD
Mailing Address - Street 2:SUITE 526
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-1312
Mailing Address - Country:US
Mailing Address - Phone:510-393-1453
Mailing Address - Fax:
Practice Address - Street 1:4200 PARK BLVD
Practice Address - Street 2:SUITE 526
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1312
Practice Address - Country:US
Practice Address - Phone:510-393-1453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG81465207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G814650Medicaid
CA110244284Medicare PIN
G70521Medicare UPIN
00G814652Medicare PIN