Basic Information
| Provider Information | |||||||||
| NPI: | 1801863329 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SHARP HEALTHCARE | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SHARP REES-STEALY CLINICS LABORATORY - FROST | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8695 SPECTRUM CENTER BLVD | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921231489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8584993027 | ||||||||
| FaxNumber: | 8584993020 | ||||||||
| Practice Location | |||||||||
| Address1: | 8010 FROST STREET | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921234284 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008274277 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2006 | ||||||||
| LastUpdateDate: | 10/21/2019 | ||||||||
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| AuthorizedOfficialLastName: | HOWARD | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO SHARP HEALTHCARE | ||||||||
| AuthorizedOfficialTelephone: | 8584994004 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | CLF1142 | CA | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.