MEDICARE: DR. KEVIN ALFRED SHAPIRO MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084V0102X	Vascular Neurology Physician	A125891	CA
2	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	A125891	CA

General Provider Information

NPI Number	:	1306006374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN ALFRED SHAPIRO MD, PHD

Provider Business Mailing Address
First Line	:	731 E WALNUT ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-1613
Country	:	US
Telephone Number	:	415-952-6050
Fax Number	:	415-789-4516

Provider Business Practice Location Address
First Line	:	776 E GREEN ST STE 205
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-5405
Country	:	US
Telephone Number	:	213-373-4003
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2008
Last Update Date	:	03/06/2026

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