Healthcare Provider Details

I. General information

NPI: 1902837362
Provider Name (Legal Business Name): VANDANA B. SHARMA M.D., PHD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6236 THORNTON AVE
NEWARK CA
94560-3732
US

IV. Provider business mailing address

PO BOX 7838
MENLO PARK CA
94026-7838
US

V. Phone/Fax

Practice location:
  • Phone: 510-248-1860
  • Fax: 510-797-0236
Mailing address:
  • Phone: 650-352-3422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberA75443
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberA75443
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: