MEDICARE: DR. SHARON UFBERG D.C.

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	111N00000X	Chiropractor	009987	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	009987	OTHER	NY	LICENSE
2	14519	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1477635829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON UFBERG D.C.

Provider Business Mailing Address
First Line	:	836 MANHATTAN AVE APT C
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-4153
Country	:	US
Telephone Number	:	510-501-0753
Fax Number	:

Provider Business Practice Location Address
First Line	:	3816 WOODRUFF AVE STE 102
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2145
Country	:	US
Telephone Number	:	510-501-0753
Fax Number	:

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	10/15/2022

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