Provider Demographics
NPI:1902095730
Name:SHARP, CHARLES F JR (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:F
Last Name:SHARP
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10 CONGRESS ST
Mailing Address - Street 2:STE 512
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3023
Mailing Address - Country:US
Mailing Address - Phone:626-449-9013
Mailing Address - Fax:626-449-8716
Practice Address - Street 1:10 CONGRESS ST
Practice Address - Street 2:STE 512
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3023
Practice Address - Country:US
Practice Address - Phone:626-449-9013
Practice Address - Fax:626-449-8716
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG21537207R00000X, 207RE0101X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG21537Medicare PIN
CAA41308Medicare UPIN