1184832719 NPI number — SHARON SOOKDEO DROST M.D.

Table of content: SHARON SOOKDEO DROST M.D. (NPI 1184832719)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184832719 NPI number — SHARON SOOKDEO DROST M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DROST
Provider First Name:
SHARON
Provider Middle Name:
SOOKDEO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SOOKDEO
Provider Other First Name:
SHARON
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1184832719
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2310 HOMESTEAD RD
Provider Second Line Business Mailing Address:
SUITE C1-201
Provider Business Mailing Address City Name:
LOS ALTOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94024-7339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-356-4777
Provider Business Mailing Address Fax Number:
408-356-4775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2450 SAMARITAN DR
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95124-3912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-356-4777
Provider Business Practice Location Address Fax Number:
408-356-4775
Provider Enumeration Date:
05/18/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  A85903 , 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)