Provider Demographics
NPI:1154542603
Name:SHARMA, PUSHPENDRA (MD)
Entity type:Individual
Prefix:DR
First Name:PUSHPENDRA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 AVAITION WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2059
Mailing Address - Country:US
Mailing Address - Phone:831-728-8250
Mailing Address - Fax:831-707-2777
Practice Address - Street 1:204 EAST BEACH STREET
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-4689
Practice Address - Country:US
Practice Address - Phone:831-728-0222
Practice Address - Fax:831-707-2777
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87911208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics