Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A31394 | CA |
NPI | 1124316575 |
---|---|
Provider Name | Ashok Kumar Sharma |
First Address | La Canada, CA 91011-3551 |
Second Address | La Canada, CA 91011-3551 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2011 |
Last Update Date | 19/07/2011 |