Provider Demographics
NPI:1962615682
Name:DRAGER, SHARON BETH (MD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:BETH
Last Name:DRAGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2089 VALE RD
Mailing Address - Street 2:SUITE 23
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3847
Mailing Address - Country:US
Mailing Address - Phone:510-237-7728
Mailing Address - Fax:
Practice Address - Street 1:2089 VALE RD
Practice Address - Street 2:SUITE 23
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3847
Practice Address - Country:US
Practice Address - Phone:510-237-7728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG312812086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G31281Medicaid
CA00G31281Medicare ID - Type Unspecified
A44710Medicare UPIN