Organization
LGIBSON ANESTHESIA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA GIBSON (PRESIDENT)
(949) 588-2190
Entity
Organization
Contact information
Practice address
9674 ARCHIBALD AVE STE 125, RANCHO CUCAMONGA, CA 91730-7944
(909) 296-8930
(909) 296-8935
Mailing address
5 HOLLAND STE 101, IRVINE, CA 92618-2568
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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