Healthcare Provider Details

I. General information

NPI: 1437321155
Provider Name (Legal Business Name): SHARON LAUGHLIN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2008
Last Update Date: 08/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 SHERMAN DR 3
RIVERSIDE CA
92503-4001
US

IV. Provider business mailing address

3838 SHERMAN DR 3
RIVERSIDE CA
92503-4001
US

V. Phone/Fax

Practice location:
  • Phone: 951-688-9800
  • Fax: 951-688-1580
Mailing address:
  • Phone: 951-688-9800
  • Fax: 951-688-1580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberG55524
License Number StateCA

VIII. Authorized Official

Name: SHARON M LAUGHLIN
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 951-688-9800