Provider Demographics
NPI:1750928297
Name:DR. EKTA SHARMA. M.D., M.P.H., INC.
Entity type:Organization
Organization Name:DR. EKTA SHARMA. M.D., M.P.H., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EKTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-839-0808
Mailing Address - Street 1:315 S DIAMOND BAR BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1616
Mailing Address - Country:US
Mailing Address - Phone:909-839-0808
Mailing Address - Fax:
Practice Address - Street 1:315 S DIAMOND BAR BLVD STE C
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1616
Practice Address - Country:US
Practice Address - Phone:909-839-0808
Practice Address - Fax:909-839-1974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty