DR. GUSTAF ISAAC GIBSON (NPI# 1215917307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215917307 |
Entity Type | Individual |
Full Name | DR. GUSTAF ISAAC GIBSON |
Credential | O.D. |
Practice Address |
34520 Bob Wilson Dr Suite 203 San Diego CA 92134-2098 |
Mailing Address |
11574 Windcrest Ln #1423 San Diego CA 92128-6403 |
Practice Telephone | 6195325840 |
Enumeration Date | 2006-01-17 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 152W00000X | Optometrist | 5823517-9934 | UT | Eye and Vision Services Providers |
X | 152W00000X | Optometrist | 2994T | OR | Eye and Vision Services Providers |
Street Address |
34520 BOB WILSON DR SUITE 203 |
City | SAN DIEGO |
State | CA |
Zip Code | 92134-2098 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932195567 | Neil Frank Gibbs | Dermatology | 34520 Bob Wilson Dr, Dermatology Department, Naval Medical Center, San Diego, CA 92134-2300 | 2005-09-20 |
1578036174 | Michael Matthew Fregolle | Military Health Care Provider | 34520 Bob Wilson Dr, San Diego, CA 92134-2098 | 2019-01-07 |
1932677499 | Emily J Thomas | Physician Assistant | 34520 Bob Wilson Dr, San Diego, CA 92134-2098 | 2018-11-02 |
1689184624 | Lisa Rene Burns | Nurse Practitioner | 34520 Bob Wilson Dr, San Diego, CA 92134-2098 | 2017-10-04 |
1154659803 | Michael William Terrenzi | Pharmacist | 34520 Bob Wilson Dr, Naval Medical Center, Pharmacy Dept. Bldg. 1 Flr. 1, San Diego, CA 92134-2098 | 2009-11-18 |
1235367327 | Paula Witherspoon | Pediatrics | 34520 Bob Wilson Dr, Department of Pediatrics, San Diego, CA 92134-2030 | 2009-06-26 |
1477780617 | Erin Beth Storie | Dermatology | 34520 Bob Wilson Dr, Suite #300, San Diego, CA 92134-2098 | 2009-06-15 |
1679771133 | Branch Medical Clinic North Island | Clinic/Center | 34520 Bob Wilson Dr, San Diego, CA 92134-2098 | 2007-07-06 |
1164558102 | Alana Sulit | Registered Nurse | 34520 Bob Wilson Dr, San Diego, CA 92134 | 2007-02-26 |
1568525319 | Carol Lynn Budzik | General Practice | 34520 Bob Wilson Dr, Suite 100, San Diego, CA 92134-2098 | 2006-12-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477178457 | Joseph Hunter Sampson | Military Health Care Provider | 34101 Farenholt Ave #14, San Diego, CA 92134 | 2020-06-15 |
1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
1255870333 | Dosh Page | Physician Assistant | Swmi Farenholt Avenue, Building 14, San Diego, CA 92134 | 2017-02-22 |
1417328063 | Noem Clay Gallego | Military Health Care Provider | 34101 Building 14, Farenholt Avenue, San Diego, CA 92134 | 2015-10-08 |
1972999183 | Justin Paul Lachney | Military Health Care Provider | 34101 Farenholt Avenue, San Diego, CA 92134 | 2015-04-14 |
1174963532 | Ryan Anders Crane | Otolaryngology | Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 | 2013-07-01 |
1447591268 | Amy B. Cornell | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, San Diego, Ca, Apo, AA 92134 | 2013-03-04 |
1841562956 | Christopher Patrick Androski Jr. | Emergency Medical Technician, Basic | Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 92134 | 2012-02-04 |
1164717740 | Jason James Weiner | Internal Medicine | Dept of Internal Medicine, Division of Rheumatology, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2011-06-13 |
1225320237 | Kimberly Ann Thompson | Student in an Organized Health Care Education/Training Program | Navy Medical Center San Diego Gme Department, 34800 Bob Wilson Dr., San Diego, CA 92134 | 2011-05-09 |
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Taxonomy Code | 152W00000X |
Grouping | Eye and Vision Services Providers |
Classification | Optometrist |
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720699432 | Emily Thai | Optometrist | 10994 W Ocean Air Dr Apt 286, San Diego, CA 92130-4635 | 2020-08-14 |
1841800018 | Luminoptix Optometry | Optometrist | 655 Saturn Blvd Ste H, San Diego, CA 92154-4734 | 2020-08-03 |
1427673680 | Courtney Lynn Cape | Optometrist | 4353 La Jolla Village Dr Ste H-20, San Diego, CA 92122-1242 | 2020-06-13 |
1073137691 | Charles Tu | Optometrist | 2150 Pacific Beach Dr Apt 234, San Diego, CA 92109-5639 | 2020-05-29 |
1538796578 | Wilson Phu | Optometrist | 3345 Rosecrans St Ste B, San Diego, CA 92110-4225 | 2020-03-26 |
1346874971 | Florena Culas | Optometrist | 7477 Goode St, San Diego, CA 92139-3931 | 2020-02-22 |
1235786633 | Courtney Hongo | Optometrist | San Diego Va 3350 La Jolla Village Dr #1125, San Diego, CA 92161-0001 | 2019-08-20 |
1467012740 | Luis G. Perez-rivera Od Optometric Corporation | Optometrist | 11134 Rancho Carmel Dr Ste 102, San Diego, CA 92128-4671 | 2019-06-18 |
1063972438 | Fabian Luna Od, Inc | Optometrist | 9855 Erma Rd Ste 130, San Diego, CA 92131-1092 | 2019-03-22 |
1790249563 | Imperial Beach Optometric Corporation | Optometrist | 1555 Palm Ave Ste A2, San Diego, CA 92154-1012 | 2019-01-25 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.