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General NPI Number Information
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NPI Number | 1700811643
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Entity Type | Individual
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Provider Name | STEVEN MICHAEL GILLIS D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 8281 MELROSE AVE 201
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City | LOS ANGELES
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State | CA
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Zip | 90046-6832
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Country | US
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Telephone | 323-655-8348
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Fax |
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Provider Business Mailing Address
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Address Line | 3466 MALAGA CT
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City | CALABASAS
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State | CA
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Zip | 91302-3076
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Country | US
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Telephone | 818-876-0720
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC21981
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License Number State | CA
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