Healthcare Provider Details

I. General information

NPI: 1194779421
Provider Name (Legal Business Name): SHARON KAY KNEPFLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 S STATE ST
HEMET CA
92543-7976
US

IV. Provider business mailing address

27699 JEFFERSON AVE SUITE 300
TEMECULA CA
92590-2661
US

V. Phone/Fax

Practice location:
  • Phone: 951-765-1777
  • Fax: 951-765-1772
Mailing address:
  • Phone: 951-252-8588
  • Fax: 951-252-8589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number4301038205
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG89000
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: