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General NPI Number Information
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NPI Number | 1821301441
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Entity Type | Individual
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Provider Name | MARIAM AFRAM SHAPERA MD
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Gender | Female
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Dates
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Enumeration Date | 07/24/2010
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 4647 ZION AVE
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City | SAN DIEGO
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State | CA
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Zip | 92120-2507
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Country | US
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Telephone | 619-528-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1536 GRANITE HILLS DR UNIT A
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City | EL CAJON
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State | CA
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Zip | 92019-6221
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Country | US
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Telephone | 313-920-2050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301094564
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A132446
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License Number State | CA
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