Provider Demographics
NPI:1245276823
Name:SHAPIRO, ROBERT HUGH (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HUGH
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8510 BALBOA BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-5810
Mailing Address - Country:US
Mailing Address - Phone:818-637-2000
Mailing Address - Fax:818-654-3417
Practice Address - Street 1:9601 S SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-5203
Practice Address - Country:US
Practice Address - Phone:310-215-6020
Practice Address - Fax:310-641-3521
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2016-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG86779207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G867790Medicaid
CA00G867790Medicaid
CAHG86779AMedicare PIN
CACB299ZMedicare PIN