Provider Demographics
NPI:1821081431
Name:SHAPIRO, LEONARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W ROMNEYA DR
Mailing Address - Street 2:# 207
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1830
Mailing Address - Country:US
Mailing Address - Phone:714-956-5200
Mailing Address - Fax:714-956-4614
Practice Address - Street 1:1801 W ROMNEYA DR STE 207
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1825
Practice Address - Country:US
Practice Address - Phone:714-956-5200
Practice Address - Fax:714-956-4614
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC27369207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA33354Medicare UPIN