Provider Demographics
NPI:1851387948
Name:SHARMA, ANUPAMA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANUPAMA
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:PO BOX 1384
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92393-1384
Mailing Address - Country:US
Mailing Address - Phone:760-241-4929
Mailing Address - Fax:760-241-5950
Practice Address - Street 1:17259 JASMINE ST
Practice Address - Street 2:SUITE B
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395
Practice Address - Country:US
Practice Address - Phone:760-241-4929
Practice Address - Fax:760-241-5950
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54985207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A549851Medicaid
G44819Medicare UPIN
CA00A549851Medicaid