Healthcare Provider Details

I. General information

NPI: 1013368752
Provider Name (Legal Business Name): SHARP HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2016
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 PROSPECT PL STE 340B
CORONADO CA
92118-1991
US

IV. Provider business mailing address

8695 SPECTRUM CENTER BLVD
SAN DIEGO CA
92123-1489
US

V. Phone/Fax

Practice location:
  • Phone: 619-522-4000
  • Fax: 619-435-0150
Mailing address:
  • Phone: 858-499-3025
  • Fax: 858-499-4738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER D. HOWARD
Title or Position: CEO & PRESIDENT
Credential:
Phone: 858-499-4003