MEDICARE: DR. DANNY M COLTON M.D., M.P.H., FICS

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	207QA0401X	Addiction Medicine (Family Medicine) Physician	A74120	CA
2	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	A74120	CA
3	208D00000X	General Practice Physician	A74120	CA
4	208VP0000X	Pain Medicine Physician	A74120	CA
5	208600000X	Surgery Physician	A74120	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	:	1831191956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANNY M COLTON M.D., M.P.H., FICS

Provider Business Mailing Address
First Line	:	17868 OUTER HIGHWAY 18
Second Line	:	SUITE # 211
City	:	APPLE VALLEY
State	:	CA
Zip	:	92307-1267
Country	:	US
Telephone Number	:	760-810-0992
Fax Number	:

Provider Business Practice Location Address
First Line	:	15366 ELEVENTH ST STE Q
Second Line	:
City	:	VICTORVILLE
State	:	CA
Zip	:	92395-3726
Country	:	US
Telephone Number	:	442-327-9131
Fax Number	:

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/08/2021

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