| Sharonya Shrivastava, | |
|
4004 Beyer Blvd, San Ysidro, CA 92173-2007 | |
| (619) 662-4100 | |
| Not Available |
| Full Name | Sharonya Shrivastava |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Location | 4004 Beyer Blvd, San Ysidro, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023646213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A186258 (California) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Entity Name | Centro De Salud De La Comunidad De San Ysidro, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124782685 PECOS PAC ID: 6901709435 Enrollment ID: O20040130000711 |
| Mailing Address | Practice Location Address |
|---|---|
| Sharonya Shrivastava, 1601 Precision Park Ln, San Ysidro, CA 92173-1345 Ph: () - | Sharonya Shrivastava, 4004 Beyer Blvd, San Ysidro, CA 92173-2007 Ph: (619) 662-4100 |
Dr. Martin Valera Consunji, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 4004 Beyer Blvd, San Ysidro, CA 92173 Phone: 619-662-4100 | |
Andrea Helen Polesky, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 4004 Beyer Blvd, San Ysidro, CA 92173 Phone: 619-662-4100 | |
Jerry Chun-han Chen, Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 4004 Beyer Blvd, San Ysidro, CA 92173 Phone: 619-662-4100 | |
Michele A. Lamantia, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 4004 Beyer Blvd, San Ysidro Health Center, San Ysidro, CA 92173 Phone: 619-917-7122 Fax: 619-474-3722 | |
Ms. Kelley Alexis Butler, MD, MPH Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 4050 Beyer Blvd, San Ysidro, CA 92173 Phone: 619-662-4100 | |
Dr. Chitra Fernando, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3364 Beyer Blvd, San Ysidro, CA 92173 Phone: 619-662-4100 |