Provider Demographics
NPI:1902837362
Name:SHARMA, VANDANA B (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:VANDANA
Middle Name:B
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD, PHD
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 7838
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94026-7838
Mailing Address - Country:US
Mailing Address - Phone:650-352-3422
Mailing Address - Fax:
Practice Address - Street 1:6236 THORNTON AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-3732
Practice Address - Country:US
Practice Address - Phone:510-248-1860
Practice Address - Fax:510-797-0236
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75443207RH0002X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI68207Medicare UPIN