Healthcare Provider Details

I. General information

NPI: 1619921707
Provider Name (Legal Business Name): BRENT A. BILLS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 LAKESIDE VLG CMNS
CHICO CA
95928-3979
US

IV. Provider business mailing address

1531 ESPLANADE ATTN: FINANCE
CHICO CA
95926-3310
US

V. Phone/Fax

Practice location:
  • Phone: 530-332-6850
  • Fax: 530-893-6857
Mailing address:
  • Phone: 530-332-7479
  • Fax: 530-893-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberG34047
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: