Healthcare Provider Details

I. General information

NPI: 1548331234
Provider Name (Legal Business Name): ANAMIKA SHARMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANAMIKA SHARMA MD

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 W YOSEMITE AVE
MANTECA CA
95337-5130
US

IV. Provider business mailing address

1721 W YOSEMITE AVE
MANTECA CA
95337-5130
US

V. Phone/Fax

Practice location:
  • Phone: 209-825-3700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA88454
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: