Healthcare Provider Details

I. General information

NPI: 1396923017
Provider Name (Legal Business Name): REBECCA LYNN GILBERT MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 08/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 MEDICAL CENTER CT
CHULA VISTA CA
91911-6617
US

IV. Provider business mailing address

PO BOX 41
MUNCIE IN
47308-0041
US

V. Phone/Fax

Practice location:
  • Phone: 619-482-5800
  • Fax:
Mailing address:
  • Phone: 765-284-0493
  • Fax: 765-284-2434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA97734
License Number StateCA

VIII. Authorized Official

Name: REBECCA LYNN GILBERT
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 858-735-5510