1851643241 NPI number — RAHUL SHARMA MD INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851643241 NPI number — RAHUL SHARMA MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAHUL 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:
Provider Other Organization Name Type Code:
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:
1851643241
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11900 HARRINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93311-9277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-664-0314
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9610 STOCKDALE HWY
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311-3625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-664-0314
Provider Business Practice Location Address Fax Number:
661-664-0997
Provider Enumeration Date:
10/09/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SHARMA
Authorized Official First Name:
RAHUL
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
661-664-0314

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  A72532 , 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: 123456 . This is a "KERN FAMILY HEALTH SYSTEMS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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