Individual
DR. BENNETT J SHILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6386 ALVARADO CT, #310, SAN DIEGO, CA 92120-4905
(619) 229-5050
(619) 287-0833
Mailing address
6386 ALVARADO CT, #310, SAN DIEGO, CA 92120-4905
(619) 229-5050
(619) 287-0833
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G71120
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G711200
—
CA
Enumeration date
11/17/2005
Last updated
12/13/2008
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