Provider Demographics
NPI:1427179050
Name:SHARMA, JASMINE VINAYAK (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:VINAYAK
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 TELSTAR AVE
Mailing Address - Street 2:SUITE 246
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2816
Mailing Address - Country:US
Mailing Address - Phone:626-644-1002
Mailing Address - Fax:
Practice Address - Street 1:9320 TELSTAR AVE
Practice Address - Street 2:SUITE 246
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2816
Practice Address - Country:US
Practice Address - Phone:626-644-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73455208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A734550OtherMEDI-CAL PROVIDER NUMBER
CACMS170162OtherSTATE OF CALIFORNIA