Organization
BOULEVARD PEDIATRICS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY F SHAPIRO MD (PRESIDENT)
(818) 783-3110
Entity
Organization
Contact information
Practice address
16550 VENTURA BLVD, STE 414, ENCINO, CA 91436-2004
(818) 783-3110
(818) 783-3115
Mailing address
16550 VENTURA BLVD, STE 414, ENCINO, CA 91436-2004
(818) 783-3110
(818) 783-3115
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A81091
CA
Other
Enumeration date
02/28/2007
Last updated
01/22/2014
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