Individual
CHARLES A SHULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
RIDGECREST REGIONAL HOSPITAL, 1081 N.CHINA LAKE ROAD, RIDGECREST, CA 93555
(760) 446-3551
Mailing address
1580 DOMINGUEZ RANCH RD, CORONA, CA 92882-7908
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G58441
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G584412
—
CA
Enumeration date
06/21/2006
Last updated
07/08/2007
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