Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | A65916 | CA |
NPI | 1366530164 |
---|---|
Provider Name | Kavita G Sharma |
First Address | Orange, CA 92868-3835 |
Second Address | Orange, CA 92868-3835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A659160 | (05) | CA |
I27965 | (02) | CA |