Elizabeth Ann Cliburn, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A8830 Issued in CA

Practice address

1721 W Yosemite Ave
Manteca, CA 95337-5130

Phone

(209) 824-5051

Fax

(209) 824-5028

NPI assigned

Nov 26, 2005

Last updated

Sep 5, 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1132963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1942283700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 WINDING RIVER CIR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952196518",
            "telephone_number": "209-824-5045",
            "fax_number": "209-824-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 W YOSEMITE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953375130",
            "telephone_number": "209-824-5051",
            "fax_number": "209-824-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIBURN",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-26",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02002820A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Young Soo Choi, DDS
• Sukalpa Chowdhury, M.D.
• Seung Ho Chung, DDS
• Rudy Ciccarelli, DDS
• Bliss Watson Clark II, M.D.
• Keith Clifton
• Derielle K Coleman, LCSW
• Ilene Collins
• Nicole Lee Collman, RN, NP, CNS
• Stephanie Colon

• Family Medicine Physician in Manteca, CA
• Providers in Manteca, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.