Colliflower, David Jon

Colliflower, David Jon is an individual health care provider with primary practice located at 22 Corporate Plaza Dr , Newport Beach CA 92660-7985. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Colliflower, David Jon can be contacted via phone (949) 722-7038.

Contact Information

Primary practice address
22 Corporate Plaza Dr Newport Beach CA 92660-7985
Phone: (949) 722-7038
Fax: (949) 630-4900
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 15993 California
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA60693871 Washington

Profile Details

NPI number 1891900346
LBN Legal business name Colliflower, David Jon
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2007
Last updated Feb 17th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891900346 NPPES
Washington MEDICAID 1891900346
Washington Other P01743785

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