Individual
DR. JARROD MATTHEW SHAPIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
795 E SECOND ST, SUITE 7, POMONA, CA 91766-2007
(909) 706-3877
(909) 706-3942
Mailing address
795 E SECOND ST, SUITE 5, POMONA, CA 91766-2007
(909) 706-3877
(909) 706-3942
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4884
CA
213EP1101X
Primary Podiatric Medicine Podiatrist
E4884
CA
213ER0200X
Radiology Podiatrist
RHD00169584
CA
213ES0000X
Sports Medicine Podiatrist
E4884
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E4884
CA
213ES0131X
Foot Surgery Podiatrist
E4884
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DL059Y
MEDICARE NO CA PTAN
CA
01
—
DL059Z
MEDICARE PTAN SO CAL
CA
Enumeration date
07/17/2006
Last updated
02/03/2017
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