Daryl E Tibbs, PA-C
Physician Assistant in Newport Beach, CA. Individual provider (NPI-1).
NPI number1265452007
StatusActive
Last updated in NPPESNov 19, 2019
Details
- NPI
- 1265452007
- Entity type
- Individual (NPI-1)
- Name
- Mr. Daryl E Tibbs
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 21, 2006
- Last updated
- Nov 19, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 001000261 | NC | Yes |
| 207N00000X | Dermatology | PA18738 | CA |
Practice location
360 San Miguel Dr Ste 501Newport Beach, CA 92660
Phone 949-720-1170
Mailing address
360 San Miguel Dr Ste 501Newport Beach, CA 92660-7831
Phone 949-720-1170 · Fax 916-773-3353
Other practice locations
360 San Miguel Dr Ste 501
Newport Beach, CA 92660
Newport Beach, CA 92660
Phone 949-720-1170
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