Active NPI
Christopher Frank Gibson, M.D.
- Specialist
- San Bernardino, CA
National Provider Identifier
1952336638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- G45993
- Practice address
- 401 E Highland Ave
Suite 251
San Bernardino, CA 92404-3803 - Phone
- (909) 881-1614
- Fax
- (909) 881-2711
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | G45993 | CA | Primary |
Addresses
Primary practice location
401 E Highland Ave
Suite 251
San Bernardino, CA 92404-3803
Mailing address
401 E Highland Ave
Suite 251
San Bernardino, CA 92404-3803
Phone (909) 881-1614
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G459932 | Other | MEDICARE INDIVIDUAL PTAN | |
| 00G459930 | Medicaid | CA | |
| G45993 | Other | CA | LICENSE |
| ZZZ07161Z | Other | MEDICARE GROUP PTAN |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corwin Medical Group Inc Ipa | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Exclusive Provider Organization
- Apple Valley, CA
- NPI 1821018433
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1952336638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 E HIGHLAND AVE",
"address_2": "SUITE 251",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924043803",
"telephone_number": "909-881-1614",
"fax_number": "909-881-2711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E HIGHLAND AVE",
"address_2": "SUITE 251",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924043803",
"telephone_number": "909-881-1614",
"fax_number": "909-881-2711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "CHRISTOPHER",
"middle_name": "FRANK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "G45993",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE INDIVIDUAL PTAN",
"identifier": "00G459932",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G459930",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "G45993",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PTAN",
"identifier": "ZZZ07161Z",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.