Provider Demographics
NPI:1265540470
Name:SHARMA, PRITHVI R (MD)
Entity type:Individual
Prefix:
First Name:PRITHVI
Middle Name:R
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2438 PONDEROSA DR N
Mailing Address - Street 2:C201
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010
Mailing Address - Country:US
Mailing Address - Phone:805-484-8479
Mailing Address - Fax:805-383-0340
Practice Address - Street 1:2438 PONDEROSA DR N
Practice Address - Street 2:C201
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010
Practice Address - Country:US
Practice Address - Phone:805-484-8479
Practice Address - Fax:805-383-0340
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA34403207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
A27473Medicare UPIN
A34403Medicare ID - Type Unspecified