MEDICARE: CHANDER SHARMA M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A30135	CA
2	207QA0505X	Adult Medicine Physician	A30135	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	330206637	OTHER		TAX I D

General Provider Information

NPI Number	:	1588778930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANDER SHARMA M.D

Provider Business Mailing Address
First Line	:	16415 COLORADO AVE STE 304
Second Line	:
City	:	PARAMOUNT
State	:	CA
Zip	:	90723-5053
Country	:	US
Telephone Number	:	562-531-4171
Fax Number	:	562-531-3596

Provider Business Practice Location Address
First Line	:	16415 COLORADO AVE STE 304
Second Line	:
City	:	PARAMOUNT
State	:	CA
Zip	:	90723-5053
Country	:	US
Telephone Number	:	562-531-4171
Fax Number	:	562-531-3596

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	02/04/2014

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