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General NPI Number Information
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NPI Number | 1699222950
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Entity Type | Organization
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Legal Business Name | DR ELLIOTT SHAPIRO, FAMILY OPTOMETRY INC.
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Dates
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Enumeration Date | 09/04/2016
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Last Update Date | 03/06/2018
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Provider Practice Location Address
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Address Line | 4353 LA JOLLA VILLAGE DR SUITE H20
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City | SAN DIEGO
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State | CA
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Zip | 92122-1259
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Country | US
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Telephone | 858-622-2165
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Fax |
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Provider Business Mailing Address
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Address Line | 7056 SITIO CALIENTE
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City | CARLSBAD
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State | CA
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Zip | 92009-2042
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Country | US
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Telephone | 858-774-2931
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELLIOTT SHAPIRO
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Credential |
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Telephone | 858-774-2931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7342
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License Number State | CA
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