Healthcare Provider Details

I. General information

NPI: 1588634398
Provider Name (Legal Business Name): DAVID SHAPIRO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 08/17/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL # SC05
MADERA CA
93636-8761
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL # SC05
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-5700
  • Fax: 559-353-5708
Mailing address:
  • Phone: 559-353-5700
  • Fax: 559-353-5708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDOS-708
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberOS14933
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number20A19875
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: