Active NPI
Cory M Clifton, IDC
- Physician Assistant
- Twentynine Palms, CA
National Provider Identifier
1407253297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 14224091-1206
- Practice address
- Box 7888260
Twentynine Palms, CA 92278-8260 - Phone
- (910) 546-1095
- NPI assigned
- Nov 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14224091-1206 | UT | Primary |
Addresses
Primary practice location
Box 7888260
Twentynine Palms, CA 92278-8260
Mailing address
44 Menusa Dr
Oceanside, CA 92058-7871
Phone (910) 546-1095
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14224091-1206 | UT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759190400000",
"number": "1407253297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 MENUSA DR",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920587871",
"telephone_number": "910-546-1095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BOX 7888260",
"city": "TWENTYNINE PALMS",
"state": "CA",
"postal_code": "922788260",
"telephone_number": "910-546-1095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLIFTON",
"first_name": "CORY",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "IDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-24",
"last_updated": "2025-09-30",
"certification_date": "2025-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "14224091-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twentynine Palms, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.