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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