Provider Demographics
NPI:1083997860
Name:SHARMA, MANISHA A (MD)
Entity type:Individual
Prefix:DR
First Name:MANISHA
Middle Name:A
Last Name:SHARMA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 GATEWAY CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-4541
Mailing Address - Country:US
Mailing Address - Phone:619-515-2300
Mailing Address - Fax:
Practice Address - Street 1:251 LANDIS AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2628
Practice Address - Country:US
Practice Address - Phone:619-515-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-41364207Q00000X
GA082054207Q00000X
OH35.135376207Q00000X
FLME139213207Q00000X
DEC1-0013097207Q00000X
CAC156518207Q00000X
DCMD041537207Q00000X
TN55009207Q00000X
NY271866207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD071727400Medicaid
MD358288YVZMedicare PIN
MD358287YWV2Medicare PIN
MD358288ZDDBMedicare PIN