Provider Demographics
NPI:1407931389
Name:SHAPIRO, STAFFORD AND YEE MEDICAL
Entity Type:Organization
Organization Name:SHAPIRO, STAFFORD AND YEE MEDICAL
Other - Org Name:SHAPIRO, STAFFORD & YEE, M.D.'S
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-446-4461
Mailing Address - Street 1:612 W DUARTE RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7602
Mailing Address - Country:US
Mailing Address - Phone:626-446-4461
Mailing Address - Fax:626-445-0647
Practice Address - Street 1:612 W DUARTE RD
Practice Address - Street 2:SUITE 304
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7602
Practice Address - Country:US
Practice Address - Phone:626-446-4461
Practice Address - Fax:626-445-0647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY48961YMedicaid
CAYYY48961YOtherBLUE SHIELD OF CALIF GR I
CAYYY48961YMedicaid
CAW2154Medicare ID - Type UnspecifiedGROUP ID#