MEDICARE: DR. GERALD SHAPIRO PHARMD

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	183500000X	Pharmacist	24377	CA

General Provider Information

NPI Number	:	1669458204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD SHAPIRO PHARMD

Provider Business Mailing Address
First Line	:	4955 CORBIN AVE
Second Line	:
City	:	TARZANA
State	:	CA
Zip	:	91356-4424
Country	:	US
Telephone Number	:	818-881-2729
Fax Number	:	818-881-9668

Provider Business Practice Location Address
First Line	:	444 S FLOWER ST
Second Line	:	SUITE #100
City	:	LOS ANGELES
State	:	CA
Zip	:	90071-2901
Country	:	US
Telephone Number	:	213-612-4300
Fax Number	:	213-612-4313

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	01/17/2008

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