| Organization Name: | BENJAMIN SHETTELL, MD |
| NPI Number: | 1689944530 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMANDA KAYE HARRIS (OFFICE MANAGER) |
| Mailing Address: | 2632 Edith Ave Ste B Redding |
| State: | CA US |
| Postal Code: | 960013031 |
| Phone Number: | 5302421227 |
| Fax Number: | 5302426078 |
| NPI Enumeration Date: | 01/10/2012 |
| NPI Last Update Date: | 01/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A106932 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |