Active NPI
Bruce Barry Grill, MD
- Pediatric Gastroenterology Physician
- Fontana, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- G48011
- Practice address
- 9961 Sierra Ave
Fontana, CA 92335-6720 - Phone
- (909) 427-3910
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G48011 | CA | |
| Pediatrics Physician | 208000000X | MD218930 | OR | |
| Pediatric Gastroenterology Physician | 2080P0206X | G48011 | CA | Primary |
Addresses
Primary practice location
9961 Sierra Ave
Fontana, CA 92335-6720
Mailing address
9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-3910
Other practice location 1
1100 Van Ness Ave Fl 7
San Francisco, CA 94109-6978
Phone (844) 733-2762
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48011 | CA | MD | Marriage & Family Therapist |
| G48011 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| LPCH Medical Group Div of Lucile | Pediatrics | Current | Accepting new patients |
| Legacy Emanuel Hospital & Health Center | Pediatrics | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340
9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979
10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000
1100 Van Ness Ave
Fl 7
San Francisco, CA 94109
Phone (415) 600-4050
1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
300 N Graham St
Ste 420
Portland, OR 97227
Phone (503) 276-6138
Interoperability endpoints
- bgrill723159@hisp.ehr.sutterhealth.org
Organizations & group practices 8
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.
-
dba Lucile Salter Packard Children's Hospital at Stanford
- Children's Hospital
- Palo Alto, CA
- NPI 1417907940
Pediatrics
-
- Health Maintenance Organization
- Riverside, CA
- NPI 1316979834
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Anaheim, CA
- NPI 1952333460
-
dba Apothecary at Emanuel Hospital
- Community/Retail Pharmacy
- Portland, OR
- NPI 1417977976
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744243200000",
"number": "1649347584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9961 SIERRA AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923356720",
"telephone_number": "909-427-3910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9961 SIERRA AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923356720",
"telephone_number": "909-427-3910"
}
],
"practiceLocations": [
{
"address_1": "1100 Van Ness Ave Fl 7",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941096978",
"country_code": "US",
"telephone_number": "844-733-2762",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRILL",
"first_name": "BRUCE",
"middle_name": "BARRY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2025-04-10",
"certification_date": "2025-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G48011",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD218930",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "CA",
"license": "G48011",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "9961 Sierra Ave",
"city": "Fontana",
"state": "CA",
"country_code": "US",
"postal_code": "923356720",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.