1609991371 NPI number — LAWRENCE A SHAPIRO, M.D., INC.

Table of content: ANNELLE GLEE MAYGREN O.D. (NPI 1477556488)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609991371 NPI number — LAWRENCE A SHAPIRO, M.D., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAWRENCE A SHAPIRO, M.D., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609991371
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7111 GARDEN GROVE BLVD
Provider Second Line Business Mailing Address:
SUITE #222
Provider Business Mailing Address City Name:
GARDEN GROVE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92841-4222
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-657-7979
Provider Business Mailing Address Fax Number:
714-657-7554

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3801 KATELLA AVE
Provider Second Line Business Practice Location Address:
SUITE# 425
Provider Business Practice Location Address City Name:
LOS ALAMITOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90720-3338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-431-2556
Provider Business Practice Location Address Fax Number:
562-596-5703
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KINNEY
Authorized Official First Name:
CYNDI
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLER
Authorized Official Telephone Number:
714-657-7979

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  C19362 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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