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Individual
KENNETH L. SHAPIRO
Active
Individual
KENNETH L. SHAPIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A31431
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A314310
BLUE SHIELD PIN
CA
01
—
10971743
CAQH NUMBER
CA
01
—
4385363
AETNA PIN
CA
01
—
A31431
CA MEDICAL LICENSE
CA
01
—
P00092287
RAILROAD MEDICARE ID
CA
Enumeration date
12/22/2005
Last updated
11/14/2014
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