1295008829 NPI number — PADMAJA SHARMA MD INC

Table of content: (NPI 1295008829)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295008829 NPI number — PADMAJA SHARMA MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PADMAJA SHARMA MD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FREMONT OB/GYN
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295008829
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3885 BEACON AVE STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREMONT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94538-1462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-796-7104
Provider Business Mailing Address Fax Number:
510-793-8154

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3885 BEACON AVE STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREMONT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94538-1462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-796-7104
Provider Business Practice Location Address Fax Number:
510-793-8154
Provider Enumeration Date:
02/13/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHARMA
Authorized Official First Name:
PADMAJA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF OFFICER
Authorized Official Telephone Number:
510-796-7104

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  A98104 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1689837569 . This is a "NPI NUMBER" identifier . This identifiers is of the category "OTHER".