Provider Demographics
NPI:1619088036
Name:SHARMA, SHASHI (MD)
Entity Type:Individual
Prefix:
First Name:SHASHI
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 MOWRY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1626
Mailing Address - Country:US
Mailing Address - Phone:510-796-0222
Mailing Address - Fax:510-796-7760
Practice Address - Street 1:2333 MOWRY AVE STE 300
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1626
Practice Address - Country:US
Practice Address - Phone:510-796-0222
Practice Address - Fax:510-796-7760
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA44662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A446620Medicaid
CAE24826Medicare UPIN
CA00A446620Medicare ID - Type Unspecified