DAVID JON COLLIFLOWER (NPI# 1891900346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891900346 |
| Entity Type | Individual |
| Full Name | DAVID JON COLLIFLOWER |
| Credential | P.A.-C |
| Practice Address |
22 Corporate Plaza Dr Newport Beach CA 92660-7985 |
| Practice Telephone | 9497227038 |
| Practice Fax Number | 9496304900 |
| Mailing Telephone | 9497227038 |
| Mailing Fax Number | 9496304900 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-02-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
15993 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA60693871 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | RR MEDICARE WVH | P01743785 | 01 |
| WA | 1891900346 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 820 N Chelan Ave, Wenatchee, WA 988012028 | 5096638711 |
| Street Address |
22 CORPORATE PLAZA DR |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92660-7985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417957093 | Ram Mudiyam | Orthopaedic Surgery | 22 Corporate Plaza Dr, Newport Beach, CA 92660-7985 | 2005-07-26 |
| 1508471921 | Cheryl Amadea Jao | Physician Assistant | 22 Corporate Plaza Dr, Newport Beach, CA 92660-7985 | 2020-09-11 |
| 1053924696 | Camille Lauren Bray | Physician Assistant | 22 Corporate Plaza Dr, Newport Beach, CA 92660-7985 | 2020-08-24 |
| 1134741770 | Vanessa Gillette | Specialist/Technologist | 22 Corporate Plaza Dr, Newport Beach, CA 92660-7985 | 2020-05-16 |
| 1902432982 | Madison Rosenbaum | Specialist/Technologist | 22 Corporate Plaza Dr, Newport Beach, CA 92660-7985 | 2020-03-21 |
| 1912495318 | James Peter Marchetti | Physician Assistant | 22 Corporate Plaza Dr, Newport Beach, CA 92660-7985 | 2018-05-01 |
| 1588192256 | Andrew James Halber | Physician Assistant | 22 Corporate Plaza Dr, Newport Beach, CA 92660-7985 | 2017-05-25 |
| 1497293666 | Brett Nishikawa | Physical Therapist | 22 Corporate Plaza Dr, 113, Newport Beach, CA 92660-7985 | 2017-02-07 |
| 1134663453 | Emily Anne Taylor | Physician Assistant | 22 Corporate Plaza Dr, Newport Beach, CA 92660-7985 | 2016-12-05 |
| 1801264569 | Laura Ann Henderson | Physical Therapist | 22 Corporate Plaza Dr, Suite 113, Newport Beach, CA 92660-7985 | 2015-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1205445798 | Felecia A Pedrogo | Marriage & Family Therapist | 5020 Campus Street, Newport Beach, CA 92660 | 2020-07-30 |
| 1649898388 | Polyviou Dental Corportation, Inc. | Clinic/Center | 120 Newport Beach Drive, Suite 27, Newport Beach, CA 92660 | 2020-07-09 |
| 1154974525 | Jan M. Eckermann, Md Inc. | Neurological Surgery | 1617 W Cliff Dr, Ste 203, Newport Beach, CA 92660 | 2019-07-24 |
| 1235792219 | Horizon Dermatology and Laser Institute | Dermatology | 369 San Miguel Dr. Suite 200, Newport Beach, CA 92660 | 2019-04-16 |
| 1902366925 | Yasmine Central Gohar | Marriage & Family Therapist | 20271 Sw Birch St Ste 200, Newport Beach, CA 92660 | 2019-03-25 |
| 1245703255 | Charison Counseling | Counselor | 4000 Macarthur Bvd Suite 600 East Tower, Newport Beach, CA 92660 | 2019-01-03 |
| 1134698996 | Amber Werner | Chiropractor | 4029 Westerly Place, Suite #115, Newport Beach, CA 92660 | 2018-11-21 |
| 1861969008 | Healthy Me Oc | Dietitian, Registered | 4569 Macarthur Court, Suite 1100, Newport Beach, CA 92660 | 2018-10-25 |
| 1174015192 | Edwin Enwia | Clinic/Center | 1000 Bristol St N Ste 1b, Newport Beach, CA 92660 | 2018-06-05 |
| Find all providers in zip 92660 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548471626 | Salpi Salibian | Physician Assistant | 520 Superior Ave Ste 225, Newport Beach, CA 92663-3667 | 2007-05-24 |
| 1366536278 | Zackry Calvin Ellis | Physician Assistant | 307 Placentia Ave Ste 111, Newport Beach, CA 92663-3307 | 2006-10-03 |
| 1659472538 | Jef Saunders | Physician Assistant | 447 Old Newport Blvd, Suite 200, Newport Beach, CA 92663-4257 | 2006-09-26 |
| 1386751121 | Yacoob Vahed | Physician Assistant | 447 Old Newport Blvd Ste 200, Newport Beach, CA 92663-4257 | 2006-08-25 |
| 1508471921 | Cheryl Amadea Jao | Physician Assistant | 22 Corporate Plaza Dr, Newport Beach, CA 92660-7985 | 2020-09-11 |
| 1255850871 | Chelsea Zysek | Physician Assistant | 3701 Birch St Ste 200, Newport Beach, CA 92660-2638 | 2017-09-14 |
| 1992175046 | Nayanna Hage | Physician Assistant | 447 Old Newport Blvd, Suite 200, Newport Beach, CA 92663-4257 | 2015-10-01 |
| 1386033017 | Lester Robertson | Physician Assistant | 3991 Macarthur Blvd, Suite 320, Newport Beach, CA 92660-3009 | 2015-01-19 |
| 1487050746 | Alyssa Friesen | Physician Assistant | 1 Hoag Dr Bldg 31, Newport Beach, CA 92663 | 2014-11-14 |
| 1699051755 | Elaine Navani | Physician Assistant | 447 Old Newport Blvd, Suite #200, Newport Beach, CA 92663-4257 | 2011-11-02 |
| Find all providers in NEWPORT BEACH | ||||
| City | NEWPORT BEACH |
| Zip Code | 92660 |
Please comment or provide details below to improve the information on DAVID JON COLLIFLOWER.
| 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.