Individual
IAN FITZ-GIBBON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3668 S SOTO ST, VERNON, CA 90058-1701
(323) 586-0218
Mailing address
2615 RAQUETA, NEWPORT BEACH, CA 92660-3510
(949) 293-1610
Taxonomy
Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
Primary
22334
CA
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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