Healthcare Provider Details

I. General information

NPI: 1891256756
Provider Name (Legal Business Name): COLTON JOHN LADBURY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 FIVEPOINT
IRVINE CA
92618-2377
US

IV. Provider business mailing address

1000 FIVEPOINT
IRVINE CA
92618-2377
US

V. Phone/Fax

Practice location:
  • Phone: 949-671-4673
  • Fax:
Mailing address:
  • Phone: 720-425-9528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA178093
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: