Healthcare Provider Details

I. General information

NPI: 1619034030
Provider Name (Legal Business Name): JAMES CHRISTOPHER CLIFFORD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 04/16/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 13TH STREET NOLF IB MEDICAL DEPARTMENT BLDG 184
IMPERIAL BEACH CA
91932
US

IV. Provider business mailing address

4552 FAIRFIELD DR
BETHESDA MD
20814-4704
US

V. Phone/Fax

Practice location:
  • Phone: 619-921-5077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01064296A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number67425
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA109342
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: