Healthcare Provider Details

I. General information

NPI: 1003425976
Provider Name (Legal Business Name): RAJ KUMAR SHARMA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 E YOSEMITE AVE STE 200
MERCED CA
95340-8201
US

IV. Provider business mailing address

7471 N FRESNO ST
FRESNO CA
93720-2457
US

V. Phone/Fax

Practice location:
  • Phone: 209-354-4675
  • Fax: 209-354-4681
Mailing address:
  • Phone: 559-436-4500
  • Fax: 559-261-1526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95014756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: