1760619936

Everything you always wanted to know about SHAPIRO MARK SAMUEL M.D. but were afraid to ask.

SHAPIRO MARK SAMUEL M.D.

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Provider Last Name Provider Middle Name Provider First Name Provider Credential
SHAPIRO MARK SAMUEL M.D.
Gender:
Male
Enumeration date:
2009-06-16
Last update date:
2010-08-01
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
207LA0401X Addiction Medicine CA G43276 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 6267956596
Practice Location Address Telephone Number 6267956596
Mailing Address Fax Number 6267968247
Practice Location Address Fax Number 6267968247

Addresses

Type Address City State Postal Country
Mailing Address 225 S LAKE AVE SUITE 535 PASADENA CA 91101 CA
Practice Location Address 225 S LAKE AVE SUITE 535 PASADENA CA 91101 CA

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Organization
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Individual
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Individual
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Organization
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Organization
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Organization
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Individual
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Organization
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Organization
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Organization
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Organization
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Individual
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Organization
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Individual
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Organization
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Organization
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Individual
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Organization
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Organization
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Individual
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Individual
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Individual
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Individual
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Organization
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Organization
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Individual
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Individual
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Organization
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Individual
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Organization
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Organization
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Individual
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Organization
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Individual
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Organization
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Individual
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Organization
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Organization
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Organization
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Individual
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Individual
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Organization
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Organization
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Organization
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Individual
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Individual
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Organization
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Individual
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Individual
225 S LAKE AVE CA PASADENA
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Individual
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