Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | A49710 | CA |
Y | 207R00000X | Internist | A49710 | CA |
Y | 111NI0900X | Internist | A49710 | CA |
NPI | 1205804580 |
---|---|
Provider Name | Ashok Sharma |
First Address | Pomona, CA 91767-5900 |
Second Address | Claremont, CA 91711-4760 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 19/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A497100 | (05) | CA |
F61200 | (02) |