Organization Active NPI

Sharna B Shachar M D a Professional Medical Corporation

  • Internal Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1033120902
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SHARNA B SHACHAR M D A PROFESSIONAL MEDICAL CORPORATION
Practice address
525 H St
Chula Vista, CA 91910-4301
Phone
(619) 409-9999
Fax
(619) 409-9905
NPI assigned
Aug 10, 2006
Last updated
Nov 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sharna B. Shachar, M.D.NPI 1619904703
Title
Owner
Phone
(619) 409-9999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

525 H St
Chula Vista, CA 91910-4301

Mailing address

525 H St
Chula Vista, CA 91910-4301
Phone (619) 409-9999

Other identifiers 1

IdentifierTypeStateIssuer
A51402OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060821000202 CA Part B Supplier - Clinic/Group Practice 7517960156 Receives reassigned benefits from 2 practitioners
Practice locations: Chula Vista, CA

National Provider Directory

National Provider Directory

Locations

525 H St
Chula Vista, CA 91910
Phone (619) 409-9999

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1033120902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 H ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104301",
            "telephone_number": "619-409-9999",
            "fax_number": "619-409-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 H ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104301",
            "telephone_number": "619-409-9999",
            "fax_number": "619-409-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARNA B SHACHAR M D A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "SHACHAR",
        "authorized_official_first_name": "SHARNA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-409-9999",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A51402",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.