Benjamin Shettell, Md | |
2632 Edith Ave Ste B Redding CA 96001-3031 | |
(530) 242-1227 | |
(530) 242-6078 |
Full Name | Benjamin Shettell, Md |
---|---|
Speciality | General Practice |
Location | 2632 Edith Ave Ste B, Redding, California |
Authorized Official Name and Position | Amanda Kaye Harris (OFFICE MANAGER) |
Authorized Official Contact | 5302421227 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Benjamin Shettell, Md 2632 Edith Ave Ste B Redding CA 96001-3031 Ph: (530) 242-1227 | Benjamin Shettell, Md 2632 Edith Ave Ste B Redding CA 96001-3031 Ph: (530) 242-1227 |
NPI Number | 1689944530 |
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Provider Enumeration Date | 01/10/2012 |
Last Update Date | 01/10/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689944530 | NPI | - | NPPES |
5774539 | Other | CA | MEDI-CAL PIN NUMBER |
DX169A | Other | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | A106932 (California) | Primary |
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