Provider Demographics
NPI:1356634489
Name:SHARMA, RAHUL (DO)
Entity type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24411 HEALTH CENTER DR STE 350
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3687
Mailing Address - Country:US
Mailing Address - Phone:949-457-7900
Mailing Address - Fax:949-588-8719
Practice Address - Street 1:24411 HEALTH CENTER DR STE 350
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3687
Practice Address - Country:US
Practice Address - Phone:949-457-7900
Practice Address - Fax:949-588-8719
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019285208600000X
CA20A146232086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery