Provider Demographics
NPI:1144253428
Name:CLIFFORD, ROYCE ELLEN (MD)
Entity type:Individual
Prefix:DR
First Name:ROYCE
Middle Name:ELLEN
Last Name:CLIFFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:132 N EL CAMINO REAL
Mailing Address - Street 2:SUITE #294
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:340 HULSE ROAD
Practice Address - Street 2:C/O NAVAL AEROSPACE MEDICINE INSTITUTE
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32508-1092
Practice Address - Country:US
Practice Address - Phone:850-452-9425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG035113207Y00000X, 2083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Not Answered2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG035113OtherCALIFORNIA LICENSE NUMBER