Provider Demographics
NPI:1366734162
Name:SHAPIRO FAMILY CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:SHAPIRO FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-565-2433
Mailing Address - Street 1:4861 CONVOY ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1610
Mailing Address - Country:US
Mailing Address - Phone:858-565-2433
Mailing Address - Fax:858-565-8504
Practice Address - Street 1:4861 CONVOY ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1610
Practice Address - Country:US
Practice Address - Phone:858-565-2433
Practice Address - Fax:858-565-8504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26993111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1518154509OtherSOLE PROPRIETOR NPI