Provider Demographics
NPI:1255387668
Name:SHARMA, ANNU G (MD)
Entity type:Individual
Prefix:DR
First Name:ANNU
Middle Name:G
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:15785 LAGUNA CANYON RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3165
Mailing Address - Country:US
Mailing Address - Phone:949-753-0901
Mailing Address - Fax:949-753-7443
Practice Address - Street 1:15785 LAGUNA CANYON RD
Practice Address - Street 2:SUITE 215
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3165
Practice Address - Country:US
Practice Address - Phone:949-753-0901
Practice Address - Fax:949-753-7443
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2011-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA43676208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A436760Medicaid
CA0566619Medicare UPIN