MEDICARE: SHARMIN QURESHI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A111438	CA

General Provider Information

NPI Number	:	1063680635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARMIN QURESHI M.D.

Provider Business Mailing Address
First Line	:	2040 FOREST AVE
Second Line	:	STE 1A
City	:	SAN JOSE
State	:	CA
Zip	:	95128-4800
Country	:	US
Telephone Number	:	408-279-9800
Fax Number	:	408-279-9801

Provider Business Practice Location Address
First Line	:	2040 FOREST AVE
Second Line	:	STE 1A
City	:	SAN JOSE
State	:	CA
Zip	:	95128-4800
Country	:	US
Telephone Number	:	408-279-9800
Fax Number	:	408-279-9801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	01/08/2020

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