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General NPI Number Information
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NPI Number | 1437498276
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Entity Type | Individual
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Provider Name | DAVID JAMES GIBSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2013
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 4830 OAK VISTA DR
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City | CARMICHAEL
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State | CA
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Zip | 95608-6207
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Country | US
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Telephone | 916-359-4369
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Fax | 916-359-4267
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Provider Business Mailing Address
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Address Line | 4830 OAK VISTA DR
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City | CARMICHAEL
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State | CA
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Zip | 95608-6207
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Country | US
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Telephone | 916-359-4365
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Fax | 916-359-4267
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | G33504
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License Number State | CA
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