Individual
DENNIS WAYNE SHULTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
710 N. BREA BLVD, STE G, BREA, CA 92821
(714) 671-1150
Mailing address
PO BOX 3010, SOUTH PASADENA, CA 91031-6718
(562) 733-1467
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A6638
CA
2083X0100X
Occupational Medicine Physician
20A6638
CA
Other
Enumeration date
12/11/2006
Last updated
04/27/2020
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