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NPI Code Detail

MEDICARE: JOANNA FRANCIS GIBBONS M.D.

MEDICARE: JOANNA FRANCIS GIBBONS M.D.
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician20A14133CA

General Provider Information

NPI Number : 1922444009
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNA FRANCIS GIBBONS M.D.
Provider Business Mailing Address
First Line : 800 S VICTORIA AVE, L4615
Second Line : VCHCA - PHYSICIAN SERVICES
City : VENTURA
State : CA
Zip : 93009-0003
Country : US
Telephone Number : 805-677-5181
Fax Number : 805-677-5304
Provider Business Practice Location Address
First Line : 506 LAKE ST
Second Line :
City : KENAI
State : AK
Zip : 99611-6937
Country : US
Telephone Number : 907-714-4025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2013
Last Update Date : 01/18/2022

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