Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 54626 | CA |
NPI | 1003975848 |
---|---|
Provider Name | Dr. Payal Sharma |
First Address | Livermore, CA 94550-4455 |
Second Address | Livermore, CA 94550-4455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2006 |
Last Update Date | 19/12/2011 |