Provider Demographics
NPI:1306686654
Name:RICHARD ALAN SHAPIRO MD INC
Entity type:Organization
Organization Name:RICHARD ALAN SHAPIRO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-996-4242
Mailing Address - Street 1:18344 CLARK ST STE 208
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3580
Mailing Address - Country:US
Mailing Address - Phone:818-996-4242
Mailing Address - Fax:
Practice Address - Street 1:18344 CLARK ST STE 208
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3580
Practice Address - Country:US
Practice Address - Phone:818-996-4242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty