Active NPI
Desmond Doss Gibson, M.D.
- Dermatology Physician
- Loma Linda, CA
National Provider Identifier
1437236189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G041983
- Practice address
- 11201 Benton St
Dept of Dermatology
Loma Linda, CA 92357-1000 - Phone
- (951) 858-5023
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | G041983 | CA | Primary |
Addresses
Primary practice location
11201 Benton St
Dept of Dermatology
Loma Linda, CA 92357-1000
Mailing address
PO Box 7547
Riverside, CA 92513-7547
Phone (951) 858-5023
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G041983 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437236189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7547",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925137547",
"telephone_number": "951-858-5023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11201 BENTON ST",
"address_2": "DEPT OF DERMATOLOGY",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923571000",
"telephone_number": "951-858-5023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "DESMOND",
"middle_name": "DOSS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G041983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.