Healthcare Provider Details

I. General information

NPI: 1528234002
Provider Name (Legal Business Name): GAURI BADHWAR SHARMA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GAURI BADHWAR D.O.

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 09/15/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LENNON LN
WALNUT CREEK CA
94598-2415
US

IV. Provider business mailing address

500 LENNON LN
WALNUT CREEK CA
94598-2415
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-9610
  • Fax: 925-939-9630
Mailing address:
  • Phone: 925-939-9610
  • Fax: 925-939-9630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number20A14448
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number5101019065
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: