Individual
PAMELA R GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1 UNIVERSITY DR, ORANGE, CA 92866-1005
(714) 997-6640
(714) 744-2161
Mailing address
1 UNIVERSITY DR, ORANGE, CA 92866-1005
(714) 997-6640
(714) 744-2161
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
860020
NATA
—
Enumeration date
01/24/2008
Last updated
01/24/2008
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