=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609079813
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAY N SCHAPIRA M D INC A PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2007
-----------------------------------------------------
Last Update Date | 06/17/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8635 W 3RD ST SUITE 750W
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90048-6101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-659-2030
-----------------------------------------------------
Fax | 310-659-1369
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8635 W 3RD ST SUITE 750W
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90048-6101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-659-2030
-----------------------------------------------------
Fax | 310-659-1369
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JAY NEIL SCHAPIRA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 310-659-2030
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------