Provider Demographics
NPI:1447486931
Name:SHARMA, YOGENDRA
Entity type:Individual
Prefix:
First Name:YOGENDRA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1074
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CA
Mailing Address - Zip Code:95368-1074
Mailing Address - Country:US
Mailing Address - Phone:209-577-0857
Mailing Address - Fax:209-566-2623
Practice Address - Street 1:4145 EASTPORT DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-8771
Practice Address - Country:US
Practice Address - Phone:209-577-0857
Practice Address - Fax:209-566-2623
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)