Provider Demographics
NPI:1649387499
Name:SHARMA, NAVEEN (MD)
Entity Type:Individual
Prefix:
First Name:NAVEEN
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N BRENT ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2822
Mailing Address - Country:US
Mailing Address - Phone:805-648-2763
Mailing Address - Fax:805-653-5639
Practice Address - Street 1:100 N BRENT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2822
Practice Address - Country:US
Practice Address - Phone:805-648-2763
Practice Address - Fax:805-653-5639
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
I26584Medicare UPIN