Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | A74120 | CA |
Y | 208200000X | Surgeon | A74120 | CA |
Y | 208600000X | Surgeon | A74120 | CA |
N | 208D00000X | General Practice Physician | A74120 | CA |
NPI | 1831191956 |
---|---|
Provider Name | Dr. Danny M Colton |
First Address | Apple Valley, CA 92307-1267 |
Second Address | Victorville, CA 92395-3726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 08/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A741200 | (05) | CA |
H32785 | (02) | CA |