Healthcare Provider Details

I. General information

NPI: 1407268790
Provider Name (Legal Business Name): EMANUEL AFRAM SHAPERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31625 DE PORTOLA RD STE 101
TEMECULA CA
92592-2770
US

IV. Provider business mailing address

1782 LAWNDALE RD
EL CAJON CA
92019-3898
US

V. Phone/Fax

Practice location:
  • Phone: 951-501-4200
  • Fax: 951-501-4239
Mailing address:
  • Phone: 619-274-6255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number174557
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME146038
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number17247
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2019020862
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDR.0071299
License Number StateCO
# 6
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberA174557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: