Individual
MR. DARYL E TIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
360 SAN MIGUEL DR STE 501, NEWPORT BEACH, CA 92660
(949) 720-1170
Mailing address
360 SAN MIGUEL DR STE 501, NEWPORT BEACH, CA 92660-7831
(949) 720-1170
(916) 773-3353
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
PA18738
CA
363A00000X
Physician Assistant
Primary
001000261
NC
Other
Enumeration date
07/21/2006
Last updated
11/19/2019
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