Provider Demographics
NPI:1700058781
Name:CLIFTON COLE, M.D., INC.
Entity Type:Organization
Organization Name:CLIFTON COLE, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-320-6677
Mailing Address - Street 1:255 N EL CIELO RD
Mailing Address - Street 2:SUITE 140-701
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6992
Mailing Address - Country:US
Mailing Address - Phone:760-320-6677
Mailing Address - Fax:760-969-7238
Practice Address - Street 1:255 N EL CIELO RD
Practice Address - Street 2:SUITE 140-701
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6992
Practice Address - Country:US
Practice Address - Phone:760-320-6677
Practice Address - Fax:760-969-7238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-30
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48556261QP2300X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G485560Medicare Oscar/Certification