Organization
PHYLLIS A CULLEN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC CULLEN (SECRETARY)
(530) 895-3287
Entity
Organization
Contact information
Practice address
274 COHASSET RD, SUITE 110, CHICO, CA 95926-2236
(530) 891-0325
Mailing address
PO BOX 1477, HILO, HI 96721-1477
(530) 895-3287
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G324032
MEDICARE INDIVIDUAL PTAN
CA
01
—
ZZZ06195Z
MEDICARE GROUP PTAN
CA
Enumeration date
10/22/2007
Last updated
12/06/2016
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