Provider Demographics
NPI:1316048226
Name:SHARKOFF, DONALD (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:SHARKOFF
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:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-0128
Mailing Address - Country:US
Mailing Address - Phone:714-828-2444
Mailing Address - Fax:714-816-0529
Practice Address - Street 1:8045 CERRITOS AVE
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:CA
Practice Address - Zip Code:90680
Practice Address - Country:US
Practice Address - Phone:714-828-2444
Practice Address - Fax:714-816-0529
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG25927207ZP0105X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BS4559487OtherDEA NUMBER
CA00G259271Medicare ID - Type Unspecified
A42840Medicare UPIN