Healthcare Provider Details

I. General information

NPI: 1316048226
Provider Name (Legal Business Name): DONALD SHARKOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8045 CERRITOS AVE
STANTON CA
90680
US

IV. Provider business mailing address

PO BOX 128
STANTON CA
90680-0128
US

V. Phone/Fax

Practice location:
  • Phone: 714-828-2444
  • Fax: 714-816-0529
Mailing address:
  • Phone: 714-828-2444
  • Fax: 714-816-0529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG25927
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberG25927
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: