Paul Mark Gibson | San Leandro, CA • PECOS Search

Paul Mark Gibson

Social Worker

Behavioral Health & Social Service Providers

545 Estudillo Ave, San Leandro, CA 94577-4611

(510) 352-9200 (415) 282-9100

PECOS Enrollment

Based on the most recent information from CMS, provider Paul Mark Gibson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1548394133
Provider Type
Individual
Full Name
Gibson, Paul Mark
Title
Mr.
Credential
LCSW

Gender
Male
Sole Proprietor
Yes
Enumeration Date
3/15/2007
Last Updated
8/6/2007

Contact Information

Practice Location

545 Estudillo Ave, San Leandro, CA 94577-4611

(510) 352-3120

Mailing Location

478 Eureka St, San Francisco, CA 94114-2715

(415) 282-9100

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License LCS11218 California