Healthcare Provider Details

I. General information

NPI: 1033118500
Provider Name (Legal Business Name): JOHN CLIFFORD GERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 S MAIN ST STE 200
ORANGE CA
92868-3845
US

IV. Provider business mailing address

396 S MAIN ST STE 200
ORANGE CA
92868-3845
US

V. Phone/Fax

Practice location:
  • Phone: 714-361-4480
  • Fax: 714-361-4490
Mailing address:
  • Phone: 714-361-4480
  • Fax: 714-361-4490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberA22900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: