Healthcare Provider Details

I. General information

NPI: 1518467695
Provider Name (Legal Business Name): STEPHEN SHARP PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2018
Last Update Date: 02/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8005 EL CAMINO REAL
ATASCADERO CA
93422-5211
US

IV. Provider business mailing address

1563 ETO CIR
SAN LUIS OBISPO CA
93405-7429
US

V. Phone/Fax

Practice location:
  • Phone: 805-462-9272
  • Fax:
Mailing address:
  • Phone: 805-440-7590
  • Fax: 805-544-7531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1193
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: