Healthcare Provider Details

I. General information

NPI: 1710037726
Provider Name (Legal Business Name): PAUL J SHAREK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WELCH RD STE 227
PALO ALTO CA
94304-1502
US

IV. Provider business mailing address

1804 EMBARCADERO RD STE 100
PALO ALTO CA
94303-3341
US

V. Phone/Fax

Practice location:
  • Phone: 650-736-0926
  • Fax: 650-497-8465
Mailing address:
  • Phone: 650-736-0926
  • Fax: 650-497-8465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG070895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: