Provider Demographics
NPI:1598859241
Name:DEBRA SHAPIRO, M.D., INC.
Entity type:Organization
Organization Name:DEBRA SHAPIRO, M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GERI
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-697-7716
Mailing Address - Street 1:1720 EL CAMINO REAL STE 120
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3225
Mailing Address - Country:US
Mailing Address - Phone:650-697-7716
Mailing Address - Fax:650-697-7165
Practice Address - Street 1:1720 EL CAMINO REAL STE 120
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3225
Practice Address - Country:US
Practice Address - Phone:650-697-7716
Practice Address - Fax:650-697-7165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID NUMBER