Individual
GERALD DOUGLAS HIBDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S.C.P.
Contact information
Practice address
4317 BLACK CANYON WAY, OCEANSIDE, CA 92057-6514
(760) 754-5212
(760) 754-5214
Mailing address
4317 BLACK CANYON WAY, OCEANSIDE, CA 92057-6514
(909) 338-2024
(909) 338-7498
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1670
CA
Other
Enumeration date
07/26/2006
Last updated
07/21/2022
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