Individual
DR. GURU DUTT SHARMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5814 VAN ALLEN WAY, SUITE 146, CARLSBAD, CA 92008-7359
(760) 421-6507
Mailing address
795 E 2ND ST, SUITE 2, POMONA, CA 91766-2007
(909) 469-8773
(909) 469-5228
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13675TLG
CA
152WC0802X
Corneal and Contact Management Optometrist
13675TLG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB228773
MEDICARE PTAN SO CAL
CA
Enumeration date
09/25/2013
Last updated
11/02/2016
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