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General NPI Number Information
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NPI Number | 1407277262
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Entity Type | Individual
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Provider Name | CHRIS CULLUM
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Gender | Male
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Dates
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Enumeration Date | 12/21/2013
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Last Update Date | 12/21/2013
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Provider Practice Location Address
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Address Line | 1280 DANA DR
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City | REDDING
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State | CA
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Zip | 96003-4038
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Country | US
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Telephone | 530-223-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 1280 DANA DR
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City | REDDING
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State | CA
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Zip | 96003-4038
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Country | US
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Telephone | 530-223-0123
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 46990
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P07187
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License Number State | MS
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