Provider Demographics
NPI:1285089037
Name:SHARP HEALTHCARE
Entity type:Organization
Organization Name:SHARP HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXERCISE SPECIALIST, MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:ACSM-CEP
Authorized Official - Phone:858-939-3482
Mailing Address - Street 1:7947 BIRMINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7947 BIRMINGHAM DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2704
Practice Address - Country:US
Practice Address - Phone:858-939-3482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
730156/1042560OtherAMERICAN COLLEGE OF SPORTS MEDICINE- CERTIFIED CLINICAL EXERCISE PHYSIOLOGIST