Doctor Name: | DR. KATHRYN A. GIBBS |
NPI Number: | 1124238308 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | G40440 |
Business Practice Address: | 9811 Ryan Cir Villa Park, CA - 928612710 |
Business Phone Number: | 7149984206 |
Business Fax Number: | 7149984206 |
Mailing Address: | 9811 Ryan Cir, VILLA PARK |
State: | CA |
Postal Code: | 928612710 |
Phone Number: | 7149984206 |
Fax Number: | 7149984206 |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | G40440 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |