Individual
MR. RALPH WILLIAM GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPT 111
Contact information
Practice address
12440 IMPERIAL HWY, SUITE 116, NORWALK, CA 90650-3177
(800) 854-7771
(562) 868-3749
Mailing address
12440 E. IMPERIAL HWY., SUITE 116, NORWALK, CA 90650-3177
(800) 854-7771
(562) 868-3749
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 19568
CA
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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