Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ryan G Gibbons

Individual provider Athletic Trainer · NPI 1780419580

Ryan G Gibbons is a Physical Therapist in Private Practice in San Diego, California. Qualified in 2025, 1 year ago. Practices with Bespoke San Diego Physical Therapy PC, a 15-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

12171 World Trade Dr
San Diego, CA 92128-3709
Phone: (858) 290-0855
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8491 Fletcher Pkwy, La Mesa, CA 91942-3005 — (619) 460-0137

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 307964 (CA)
Athletic Trainer Taxonomy 2255A2300X · Licence 2000042459 (CA)

Record details

NPI number1780419580
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 3, 2024
Last updated in NPPESMay 9, 2025
Certification dateMay 9, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Bespoke San Diego Physical Therapy Pc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in San Diego