Clifton Deshaun Malcom

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

1996 Issued in CA

Practice address

66659 El Dorado PL
Desert Hot Springs, CA 92240-6977

Phone

(760) 660-3961

NPI assigned

Apr 15, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1306409461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66659 EL DORADO PL",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922406977",
            "telephone_number": "760-660-3961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66659 EL DORADO PL",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922406977",
            "telephone_number": "760-660-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOM",
        "first_name": "CLIFTON",
        "middle_name": "DESHAUN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": "1996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jassmin M Luevano
• Maria Louise Lynch
• Akua Two Hawk W. Renee Maat
• Lionel G Madrigal
• Elma Mahmic, AMFT
• Camille Mamudu, PPS
• Lisa Christine Mann, RADT
• Joseph Marks
• Adara Sarahi Marquez
• Alicia Marquez, PH.D., LMFT

• Non-emergency Medical Transport (VAN) in Desert Hot Springs, CA
• Providers in Desert Hot Springs, CA by specialty
• Non-emergency Medical Transport (VAN) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.