Organization
PEDIATRIC UROLOGY MEDICAL GROUP, INC.
Active
Organization
PEDIATRIC UROLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN R. SHAPIRO M.D. (PEDIATRIC UROLOGIST)
(916) 649-8991
Entity
Organization
Contact information
Practice address
87 SCRIPPS DR, SUITE 114, SACRAMENTO, CA 95825-6372
(916) 649-8991
Mailing address
87 SCRIPPS DR, SUITE 114, SACRAMENTO, CA 95825-6372
(916) 649-8991
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
G22205
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0069580
—
CA
Enumeration date
12/05/2006
Last updated
08/22/2020
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