Healthcare Provider Details

I. General information

NPI: 1659132207
Provider Name (Legal Business Name): SHARIA BOKHARI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 KENTUCKY ST
GRIDLEY CA
95948-2116
US

IV. Provider business mailing address

520 KENTUCKY ST
GRIDLEY CA
95948-2116
US

V. Phone/Fax

Practice location:
  • Phone: 530-846-6231
  • Fax:
Mailing address:
  • Phone: 530-846-6231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberPA68515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: