Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC 19278 | CA |
NPI | 1275610842 |
---|---|
Provider Name | Mr. Mark B. Shapiro |
First Address | Oakland, CA 94609-3149 |
Second Address | Oakland, CA 94609-3149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 09/09/2008 |