Individual
BRETT GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1906 FORT JONES RD, YREKA, CA 96097-9530
(530) 842-9060
Mailing address
1906 FORT JONES RD, YREKA, CA 96097-9530
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
63548
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63548
BOARD OF PHARMACY LICENSE
CA
Enumeration date
05/08/2024
Last updated
05/08/2024
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