Provider Demographics
NPI:1891893061
Name:SHARKOFF, JAMES ANGELO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANGELO
Last Name:SHARKOFF
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 1:8045 CERRITOS AVE
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680
Mailing Address - Country:US
Mailing Address - Phone:714-828-2444
Mailing Address - Fax:714-816-0529
Practice Address - Street 1:8045 CERRITOS AVE
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:CA
Practice Address - Zip Code:90680-2436
Practice Address - Country:US
Practice Address - Phone:714-828-2444
Practice Address - Fax:714-816-0529
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66728207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A66728Medicaid
CA00A66728Medicaid