Provider Demographics
NPI:1447267091
Name:SHARMA, SALILA (MD)
Entity type:Individual
Prefix:MRS
First Name:SALILA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4955 VAN NUYS BLVD
Mailing Address - Street 2:#719
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1801
Mailing Address - Country:US
Mailing Address - Phone:818-906-9805
Mailing Address - Fax:818-906-3141
Practice Address - Street 1:4955 VAN NUYS BLVD
Practice Address - Street 2:#719
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1801
Practice Address - Country:US
Practice Address - Phone:818-906-9805
Practice Address - Fax:818-906-3141
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40175207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A401750Medicaid
E98816Medicare UPIN
CAA40175Medicare ID - Type Unspecified