Healthcare Provider Details

I. General information

NPI: 1700058781
Provider Name (Legal Business Name): CLIFTON COLE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2008
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40101 MONTEREY AVE STE B1-314
RANCHO MIRAGE CA
92270-3261
US

IV. Provider business mailing address

40101 MONTEREY AVENUE SUITE B1-314
RANCHO MIRAGE CA
92270
US

V. Phone/Fax

Practice location:
  • Phone: 760-320-6677
  • Fax: 760-969-7238
Mailing address:
  • Phone: 760-320-6677
  • Fax: 760-969-7238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberG48556
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberG48556
License Number StateCA

VIII. Authorized Official

Name: CLIFTON COLE
Title or Position: PRESIDENT/CEO
Credential: M.D.
Phone: 760-320-6677