| Doctor Name: | DR. TERRENCE EDWARD TIBBELS |
| NPI Number: | 1154436517 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | C31826 |
| Business Practice Address: | 9745 Prospect Ave #100 Santee, CA - 920716209 |
| Business Phone Number: | 6194484841 |
| Business Fax Number: | 6194488700 |
| Mailing Address: | 3991 Scott Dr, CARLSBAD |
| State: | CA |
| Postal Code: | 920083625 |
| Phone Number: | 7607295031 |
| Fax Number: | |
| NPI Enumeration Date: | 08/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C31826 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |