Individual provider Active NPI

Gary G. Bruton, PSY.D.

  • Cognitive & Behavioral Psychologist
  • Beverly Hills, CA
National Provider Identifier
1306069356
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
PSY16499 Issued in CA
Practice address
420 S Beverly Dr
100-14
Beverly Hills, CA 90212-4426
Phone
(310) 365-8581
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X PSY16499 CA Primary

Addresses

Primary practice location

420 S Beverly Dr
100-14
Beverly Hills, CA 90212-4426

Mailing address

PO Box 352040
Los Angeles, CA 90035-0230
Phone (310) 652-9543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121220000080 CA Practitioner - Clinical Psychologist 8921250952 Practice locations: Beverly Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

420 S Beverly Dr
Suite 100
Beverly Hills, CA 90212-4410
Phone (310) 365-8581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306069356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 352040",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900350230",
            "telephone_number": "310-652-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S BEVERLY DR",
            "address_2": "100-14",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902124426",
            "telephone_number": "310-365-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUTON",
        "first_name": "GARY",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY16499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.