Active NPI
Clifford Ray Jordan, MD
- Anesthesiology Physician
- Newport Beach, CA
National Provider Identifier
1649571126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- AFE28904
- Practice address
- 1212 Santiago Dr.
Newport Beach, CA 92660 - Phone
- (949) 631-2310
- Fax
- (949) 642-6942
- NPI assigned
- Nov 15, 2010
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | AFE28904 | CA | Primary |
Addresses
Primary practice location
1212 Santiago Dr.
Newport Beach, CA 92660
Mailing address
1212 Santiago Dr.
Newport Beach, CA 92660
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AFE28904 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289779200000",
"number": "1649571126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 SANTIAGO DR.",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "92660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 SANTIAGO DR.",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "92660",
"telephone_number": "949-631-2310",
"fax_number": "949-642-6942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "CLIFFORD",
"middle_name": "RAY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-15",
"last_updated": "2010-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "AFE28904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.