Healthcare Provider Details

I. General information

NPI: 1891145850
Provider Name (Legal Business Name): ABDULLAH SHARAF M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S MAIN ST STE 108
CORONA CA
92882-3401
US

IV. Provider business mailing address

15900 ELLINGTON WAY
CHINO HILLS CA
91709-7965
US

V. Phone/Fax

Practice location:
  • Phone: 951-734-5450
  • Fax: 951-734-6009
Mailing address:
  • Phone: 517-944-4880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301110540
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: