Ryan Patrick Gillis | San Diego, CA • PECOS Search

Ryan Patrick Gillis

Pediatrics

Allopathic & Osteopathic Physicians

3020 Children'S Way, Rady Children'S Hospital San Diego, San Diego, CA 92123

(858) 966-8052 (619) 532-6474

PECOS Enrollment

Based on the most recent information from CMS, provider Ryan Patrick Gillis does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 2:29 PM.

Profile Details

Provider ID
1629502281
Provider Type
Individual
Full Name
Gillis, Ryan Patrick
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
4/20/2017
Last Updated
7/5/2024

Contact Information

Practice Location

3020 Children'S Way, Rady Children'S Hospital San Diego, San Diego, CA 92123

Unlisted Fax

Mailing Location

Naval Medical Ctr, 34800 Bob Wilson Drive, San Diego, CA 92134-5000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208000000X Primary	Description Pediatrics Allopathic & Osteopathic Physicians	License A157437 California
Code 2080P0210X	Description Pediatrics Allopathic & Osteopathic Physicians	License FELLOW California