Individual
DR. DOUGLAS N. GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,
Contact information
Practice address
10666 N TORREY PINES RD, LA JOLLA, CA 92037-1027
(858) 554-8730
Mailing address
FILE # 54433, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A69985
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A699850
BLUE SHIELD OF CA
—
05
—
00A699850
—
CA
01
—
F900
CHAMPUS
—
01
—
P00393491
RAILROAD MEDICARE
—
Enumeration date
05/17/2006
Last updated
06/25/2009
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