Provider Demographics
NPI:1760561815
Name:SHARMA, KRUPA S (MD)
Entity Type:Individual
Prefix:
First Name:KRUPA
Middle Name:S
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRUPA
Other - Middle Name:N
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5380 PIRRONE RD STE 301A
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CA
Mailing Address - Zip Code:95368-9132
Mailing Address - Country:US
Mailing Address - Phone:209-846-9488
Mailing Address - Fax:
Practice Address - Street 1:5380 PIRRONE RD STE 301A
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CA
Practice Address - Zip Code:95368-9132
Practice Address - Country:US
Practice Address - Phone:209-846-9488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94928207RH0002X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A949280Medicare ID - Type Unspecified