Individual
O. HOWARD SHATTUCK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
11370 ANDERSON ST, STE 2100, LOMA LINDA, CA 92354-3450
(909) 558-2822
Mailing address
54701 FILE NUMBER, LOS ANGELES, CA 90074-4701
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10544
CA
Other
Enumeration date
09/20/2006
Last updated
09/24/2007
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