Individual
MICHAEL SPENCER GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4060 FAIRMOUNT AVE STE 120, SAN DIEGO, CA 92105-1608
(619) 269-1299
(619) 961-0812
Mailing address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
(619) 997-4859
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
D54010
MD
2085R0202X
Diagnostic Radiology Physician
Primary
C54766
CA
Other
Enumeration date
09/22/2005
Last updated
11/14/2022
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