Provider Demographics
NPI:1922187491
Name:ANWAR, SHAMA J (PA)
Entity Type:Individual
Prefix:MRS
First Name:SHAMA
Middle Name:J
Last Name:ANWAR
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:6001 BOLLINGER CANYON RD.
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583
Mailing Address - Country:US
Mailing Address - Phone:925-842-2995
Mailing Address - Fax:925-842-2046
Practice Address - Street 1:6001 BOLLINGER CANYON RD.
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583
Practice Address - Country:US
Practice Address - Phone:925-842-2995
Practice Address - Fax:925-842-2046
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2018-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT3082825-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant