Provider Demographics
NPI:1316154065
Name:PREMINGER SHARMA, SYLVIA A (MD)
Entity type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:A
Last Name:PREMINGER SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:PREMINGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1020 SANTIAGO DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:949-468-8161
Mailing Address - Fax:
Practice Address - Street 1:2701 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92628
Practice Address - Country:US
Practice Address - Phone:714-432-5808
Practice Address - Fax:714-432-5115
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41109208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice