Provider Demographics
NPI:1780143537
Name:SHARMA, MUNISH NA (NA)
Entity type:Individual
Prefix:MR
First Name:MUNISH
Middle Name:NA
Last Name:SHARMA
Suffix:
Gender:M
Credentials:NA
Other - Prefix:MR
Other - First Name:MUNISH
Other - Middle Name:
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MUNISH SHARMA
Mailing Address - Street 1:27333 FAHREN CT APT 205
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-6074
Mailing Address - Country:US
Mailing Address - Phone:909-414-5815
Mailing Address - Fax:
Practice Address - Street 1:27333 FAHREN CT APT 205
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-6074
Practice Address - Country:US
Practice Address - Phone:909-414-5815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7SNA294347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle