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Organization
BENJAMIN SHETTELL, MD
Active
Organization
BENJAMIN SHETTELL, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA KAYE HARRIS (OFFICE MANAGER)
(530) 242-1227
Entity
Organization
Contact information
Practice address
2632 EDITH AVE STE B, REDDING, CA 96001-3031
(530) 242-1227
(530) 242-6078
Mailing address
2632 EDITH AVE STE B, REDDING, CA 96001-3031
(530) 242-1227
(530) 242-6078
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A106932
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5774539
MEDI-CAL PIN NUMBER
CA
01
—
DX169A
MEDICARE PTAN
—
Enumeration date
01/10/2012
Last updated
01/10/2012
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