Ellison H Cordray, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

G66464 Issued in CA

Practice address

1800 No California Street
Stockton, CA 95204-0000

Phone

(209) 473-6555

Fax

(209) 473-6544

NPI assigned

Oct 3, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1033204490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 W MARCH LANE",
            "address_2": "SUITE 200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192370",
            "telephone_number": "209-473-6555",
            "fax_number": "209-473-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NO CALIFORNIA STREET",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952040000",
            "telephone_number": "209-473-6555",
            "fax_number": "209-473-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDRAY",
        "first_name": "ELLISON",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "G66464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "G66464",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Genoveve Cordova
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• Michelle Cordova
• Vida B. Cordova, MD
• Core Anesthesia Provider Services PC
• Core Anesthesia Services PC
• Core Labs and Diagnostic
• Allan B Corey
• Corky Hul Medical Assoc (NorCal Occupational Med Center)

• Emergency Medical Services (Emergency Medicine) Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Emergency Medical Services (Emergency Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.