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NPI Code Detail

MEDICARE: NICHOLAS LANE GIBSON DC

MEDICARE:   NICHOLAS LANE GIBSON  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor37634CA

General Provider Information

NPI Number : 1609709781
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS LANE GIBSON DC
Provider Business Mailing Address
First Line : 535 H ST
Second Line :
City : CHULA VISTA
State : CA
Zip : 91910-4301
Country : US
Telephone Number : 619-409-9000
Fax Number :
Provider Business Practice Location Address
First Line : 535 H ST
Second Line :
City : CHULA VISTA
State : CA
Zip : 91910-4301
Country : US
Telephone Number : 619-409-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ NICHOLAS LANE GIBSON DC” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.