Bullis Family Medical
Family Medicine in Inglewood, CA. Organization (NPI-2).
NPI number1104084623
StatusActive
Last updated in NPPESJun 2, 2008
Details
- NPI
- 1104084623
- Entity type
- Organization (NPI-2)
- Legal business name
- Bullis Family Medical
- Organization subpart
- No
- Enumeration date
- May 30, 2008
- Last updated
- Jun 2, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | G46679 | CA | Yes |
Practice location
248 N Locust StInglewood, CA 90301-1258
Phone 310-673-3737 · Fax 310-673-0248
Mailing address
248 N Locust StInglewood, CA 90301-1258
Phone 310-673-3737 · Fax 310-673-0248
Authorized official
Bambi L. Nickelberry
Physician
3106733737
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