Marc R Shapiro Medical Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G34359 Issued in CA

Legal business name

MARC R SHAPIRO MEDICAL CORP

Practice address

3400 Emerson St
Suite a
Clearlake, CA 95422-9529

Phone

(707) 994-7241

Fax

(707) 994-0870

NPI assigned

Apr 22, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marc Randall Shapiro, MD

Title

Ceo

Phone

(707) 994-7241

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Young, M.D.

  • Ophthalmology Physician
  • Clearlake, CA
  • NPI 1710984422
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251417600000",
    "number": "1235373184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 EMERSON ST",
            "address_2": "SUITE A",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229529",
            "telephone_number": "707-994-7241",
            "fax_number": "707-994-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 EMERSON ST",
            "address_2": "SUITE A",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229529",
            "telephone_number": "707-994-7241",
            "fax_number": "707-994-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC R SHAPIRO MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-22",
        "last_updated": "2009-08-28",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-994-7241",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G34359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DP1119",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235373184",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyons Huber Management
• Siqi Ma, DO
• Junirose Macdonald, BCBA
• Katrice Christine Maliszewski
• Carol Louine Mansfield, RI
• Mark Freeman, MD
• Gail Marquette, FNP
• Brian James Marrier, BCAB
• Teresa Massingill
• Sheila Jane McCarthy

• Internal Medicine Physician in Clearlake, CA
• Providers in Clearlake, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.