Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | A147567 | CA |
NPI | 1003233073 |
---|---|
Provider Name | Douglas Shapiro |
First Address | Los Angeles, CA 90010-2814 |
Second Address | Los Angeles, CA 90027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2014 |
Last Update Date | 08/11/2018 |