Healthcare Provider Details

I. General information

NPI: 1528070737
Provider Name (Legal Business Name): JOSEPH SHAPIRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12660 RIVERSIDE DR STE 325
STUDIO CITY CA
91607-3404
US

IV. Provider business mailing address

12660 RIVERSIDE DR STE 325
STUDIO CITY CA
91607-3404
US

V. Phone/Fax

Practice location:
  • Phone: 818-837-2753
  • Fax: 818-898-9282
Mailing address:
  • Phone: 818-837-2753
  • Fax: 818-898-9282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA77622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: