Healthcare Provider Details

I. General information

NPI: 1891292850
Provider Name (Legal Business Name): NAVEEN SHARMA, MD INC A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 04/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2438 N PONDEROSA DR STE C201
CAMARILLO CA
93010-2374
US

IV. Provider business mailing address

2438 N PONDEROSA DR STE C201
CAMARILLO CA
93010-2374
US

V. Phone/Fax

Practice location:
  • Phone: 805-484-4612
  • Fax:
Mailing address:
  • Phone: 805-484-4612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA97189
License Number StateCA

VIII. Authorized Official

Name: DEBBIE SEVERNS
Title or Position: OFFICE ADMIN
Credential:
Phone: 805-484-4612