DAVID JON COLLIFLOWER P.A.-C NPI 1891900346

NPI Information

NPI: 1891900346
Provider Name: DAVID JON COLLIFLOWER, P.A.-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
22 CORPORATE PLAZA DR
NEWPORT BEACH, CA
ZIP 92660
Phone: (949) 722-7038
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David Jon Colliflower, P.A.-C is a surgical physician assistant in Newport Beach, CA with 23 years of experience. David Jon Colliflower, P.A.-C NPI is 1891900346. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

22 CORPORATE PLAZA DR
NEWPORT BEACH, CA
ZIP 92660-985
Phone: (949) 722-7038
Fax: (949) 630-4900

The NPI 1891900346 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/10/2007 and was last updated on 2/17/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	15993	CALIFORNIA	Yes
2	363AS0400X	Physician Assistant	Surgical	PA60693871	WASHINGTON	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P01743785	OTHER	WASHINGTON	RR MEDICARE WVH
2	1891900346	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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