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Contact Information

KELLY GIBSONCHIROPRACTIC, INC
1929 W VISTA WAY
SUITE C
VISTA, CA92083-6004
 Phone: 760-724-5700
 Fax: 760-724-9878
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internist

111NI0900X 35 Chiropractic
 

Chiropractor - Nutrition

111NN1001X 35 Chiropractic
 

Rehabilitation

111NR0400X 35 Chiropractic
 

Sports Physician

111NS0005X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for KELLY GIBSONCHIROPRACTIC, INC

NPI Number 1336686153
LBN Legal business name KELLY GIBSONCHIROPRACTIC, INC
Authorized official KELLY GIBSON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/31/2017
Last updated 01/31/2017 - About 9 years ago
Identifiers
CA License # DC10902
CA License # DC25328
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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