Basic Information
Provider Information
NPI: 1033433909
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAPLETON
FirstName: SHARINA
MiddleName: MARY
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 27200 IRIS AVE
Address2: MOB2
City: MORENO VALLEY
State: CA
PostalCode: 925554803
CountryCode: US
TelephoneNumber: 9513532000
FaxNumber:  
Practice Location
Address1: 27200 IRIS AVE
Address2: MOB2
City: MORENO VALLEY
State: CA
PostalCode: 925554803
CountryCode: US
TelephoneNumber: 9513532000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/22/2010
LastUpdateDate: 10/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X20A14166CAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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