1578500658 NPI number — ZACHARY SHARMAN D.O.

Table of content: ZACHARY SHARMAN D.O. (NPI 1578500658)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578500658 NPI number — ZACHARY SHARMAN D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHARMAN
Provider First Name:
ZACHARY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHARMAN
Provider Other First Name:
ZACHARY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1578500658
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3955
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PINEDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93650-3955
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-353-3927
Provider Business Mailing Address Fax Number:
559-432-8302

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7409 N CEDAR AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93720-3836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-353-3927
Provider Business Practice Location Address Fax Number:
559-432-8302
Provider Enumeration Date:
05/31/2006

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: 2084P0800X , with the licence number:  20A8947 , 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: 20A8947 . This is a "CA MEDICAL LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com