Bullis Family Medical

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G46679 Issued in CA

Legal business name

BULLIS FAMILY MEDICAL

Practice address

248 N Locust St
Inglewood, CA 90301-1258

Phone

(310) 673-3737

Fax

(310) 673-0248

NPI assigned

May 30, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Bambi L. Nickelberry, M.D.

Title

Physician

Phone

(310) 673-3737

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1104084623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 N LOCUST ST",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011258",
            "telephone_number": "310-673-3737",
            "fax_number": "310-673-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 N LOCUST ST",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011258",
            "telephone_number": "310-673-3737",
            "fax_number": "310-673-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULLIS FAMILY MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "NICKELBERRY",
        "authorized_official_first_name": "BAMBI",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "310-673-3737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G46679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Lynn Brown, MFT
• Elaine Brumley
• Sommer Bryant
• Jazmin M Buford
• Adele Bulahan, FNP-C
• Javier Christopher Burboa, PA-C
• Kristin Janette Burch, MSW
• Andre Burgess, D.D.S.
• Rogena Burrus, RNP
• Butterfly Love Residential Care Home LLC

• Family Medicine Physician in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.