Provider Demographics
NPI:1518154509
Name:SHAPIRO, STANLEY PHILLIP (DC)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:PHILLIP
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26993111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor