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NPI Code Detail

MEDICARE: MS. SHARON HARDY RD

MEDICARE: MS. SHARON HARDY RD
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
1133V00000XRegistered Dietitian921604CA

General Provider Information

NPI Number : 1588742589
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHARON HARDY RD
Provider Business Mailing Address
First Line : 1437 CERRITOS DR
Second Line :
City : LAGUNA BEACH
State : CA
Zip : 92651-2818
Country : US
Telephone Number : 949-463-8241
Fax Number :
Provider Business Practice Location Address
First Line : 1437 CERRITOS DR
Second Line :
City : LAGUNA BEACH
State : CA
Zip : 92651-2818
Country : US
Telephone Number : 949-715-3634
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 05/28/2009

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