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General NPI Number Information
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NPI Number | 1508966508
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Entity Type | Individual
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Provider Name | SAMIR SHARMA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14651 S BASCOM AVE SUITE 280
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City | LOS GATOS
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State | CA
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Zip | 95032-2014
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Country | US
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Telephone | 408-356-9422
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Fax | 408-356-9042
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Provider Business Mailing Address
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Address Line | 2237 QUAIL BLUFF CT
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City | SAN JOSE
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State | CA
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Zip | 95121-3210
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Country | US
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Telephone | 530-294-1136
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Fax | 530-294-1143
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | A27947
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License Number State | CA
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