MEDICARE: DR. WARREN DAVID CLIFT M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104992635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WARREN DAVID CLIFT M.D

Provider Business Mailing Address
First Line	:	2815 N CALIFORNIA ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-3738
Country	:	US
Telephone Number	:	209-466-3552
Fax Number	:

Provider Business Practice Location Address
First Line	:	2815 N CALIFORNIA ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-3738
Country	:	US
Telephone Number	:	209-466-3551
Fax Number	:	209-465-7437

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	01/30/2008

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