Provider Demographics
NPI:1821263302
Name:SHAPERO, MYRON SAUL (MD)
Entity Type:Individual
Prefix:
First Name:MYRON
Middle Name:SAUL
Last Name:SHAPERO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:99 N LA CIENEGA BLVD
Mailing Address - Street 2:107
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2222
Mailing Address - Country:US
Mailing Address - Phone:323-856-7201
Mailing Address - Fax:805-565-9557
Practice Address - Street 1:153 SO. LASKY DR. - SUITE 3
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212
Practice Address - Country:US
Practice Address - Phone:310-600-1336
Practice Address - Fax:805-565-9557
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2022-01-19
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Provider Licenses
StateLicense IDTaxonomies
CAA19800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG19800OtherMEDICARE #
CAG19800OtherMEDICARE #