MEDICARE: GAURI BADHWAR SHARMA D.O.

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	207RH0000X	Hematology (Internal Medicine) Physician	20A14448	CA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207RH0003X	Hematology & Oncology Physician	5101019065	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20A14448	OTHER	CA	CA LICENSE

General Provider Information

NPI Number	:	1528234002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAURI BADHWAR SHARMA D.O.

Provider Business Mailing Address
First Line	:	500 LENNON LN
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-2415
Country	:	US
Telephone Number	:	925-939-9610
Fax Number	:	925-939-9630

Provider Business Practice Location Address
First Line	:	500 LENNON LN
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-2415
Country	:	US
Telephone Number	:	925-939-9610
Fax Number	:	925-939-9630

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

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	09/15/2020

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