Bruce S Gillis, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G30367 Issued in CA

Practice address

11801 W Olympic Blvd
Los Angeles, CA 90064-1114

Phone

(310) 268-1001

Fax

(310) 268-1015

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Epicgenetics, Inc.

  • Clinical Medical Laboratory
  • Los Angeles, CA
  • NPI 1639588890
  NPD Authorized official
• Immunology Diagnostics LLC

  • Clinical Medical Laboratory
  • Santa Monica, CA
  • NPI 1134825219
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1013945542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11801 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641114",
            "telephone_number": "310-268-1001",
            "fax_number": "310-268-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641114",
            "telephone_number": "310-268-1001",
            "fax_number": "310-268-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "BRUCE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G30367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Gilliam, LMFT
• Scott Duncan Gilliam, MFT
• Rezal Gillies
• Frank Davis Gilliland, M.D.
• Artha Je Gillis, MD
• Dominique A Gillis, MFT
• Joanna Lesli Gillis, LCSW
• Steven Michael Gillis, D.C.
• Phyllis Gillman, PH.D.
• Arlene Tubiera Gillo, L.AC.

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.