Healthcare Provider Details

I. General information

NPI: 1144686353
Provider Name (Legal Business Name): ASHWYN KAMAL SHARMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2016
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 CAMPUS POINT DR # 7220
LA JOLLA CA
92037-1300
US

IV. Provider business mailing address

733 RUTLAND AVENUE THE JOHNS HOPKINS SCHOOL OF MEDICINE
BALTIMORE MD
21205-2109
US

V. Phone/Fax

Practice location:
  • Phone: 858-657-7025
  • Fax:
Mailing address:
  • Phone: 410-955-3080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA166155
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: