Organization
SAN FERNANDO VALLEY UROL ASSOC MED
Active
Other names
San Fernando Valley Urological Associates Medical Group Inc
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD SHAPIRO MD (PRESIDENT)
(818) 996-4242
Entity
Organization
Contact information
Practice address
18370 BURBANK BLVD, STE 407, TARZANA, CA 91356-2804
(818) 996-4242
(818) 996-4352
Mailing address
18370 BURBANK BLVD, STE 407, TARZANA, CA 91356-2804
(818) 996-4242
(818) 996-4352
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP5338
RAILROAD MEDICARE
CA
01
—
ZZZ16738Z
BLUE SHIELD
CA
05
—
ZZZ49135Z
—
CA
Enumeration date
07/08/2006
Last updated
01/03/2014
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