Provider Demographics
NPI:1528070737
Name:SHAPIRO, JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12660 RIVERSIDE DR
Mailing Address - Street 2:STE 325
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3404
Mailing Address - Country:US
Mailing Address - Phone:818-837-2753
Mailing Address - Fax:818-898-9282
Practice Address - Street 1:12660 RIVERSIDE DR
Practice Address - Street 2:STE 325
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91607-3404
Practice Address - Country:US
Practice Address - Phone:818-837-2753
Practice Address - Fax:818-898-9282
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77622207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGMedicare UPIN