Provider Demographics
NPI:1407994429
Name:GIBBS, IRIS C (MD)
Entity type:Individual
Prefix:DR
First Name:IRIS
Middle Name:C
Last Name:GIBBS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:875 BLAKE WILBUR DRIVE
Mailing Address - Street 2:ROOM G222A
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5847
Mailing Address - Country:US
Mailing Address - Phone:650-723-6171
Mailing Address - Fax:650-725-8231
Practice Address - Street 1:875 BLAKE WILBUR DR
Practice Address - Street 2:MC 5847
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2205
Practice Address - Country:US
Practice Address - Phone:650-723-6171
Practice Address - Fax:650-725-8231
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2013-12-12
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Provider Licenses
StateLicense IDTaxonomies
CAA615892085R0001X, 2085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A615890Medicaid
CA00A615890Medicaid
CAH14847Medicare UPIN