Stevan Ray Clark in Los Angeles - Specialist
Stevan Ray Clark - NPI 1376616227
Stevan Ray Clark is a Specialist in Los Angeles, California. Stevan Ray Clark practices all healthcare services and medical treatments related to Specialist. The NPI Number for Stevan Ray Clark is 1376616227. The last update date is 2007-07-08.
Stevan Ray Clark's current location address is 10220 S Western Ave, Los Angeles, California. You can contact this provider via phone number 3237571744 and fax number 3237573818. The mailing address for Stevan Ray Clark is 10220 S Western Ave, Los Angeles, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stevan Ray Clark |
|---|---|
| Address | 10220 S Western Ave, Los Angeles, California |
| Phone Number | 3237571744 |
| Fax Number | 3237573818 |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1376616227 |
|---|---|
| Provider Enumeration Date | 2006-11-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 10220 S Western Ave |
|---|---|
| City | Los Angeles |
| State | California (CA) |
| Post Code | 900474258 |
| Phone Number | 3237571744 |
| Fax Number | 3237573818 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | G63102 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00G631020 | CA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Stevan Ray Clark by the Centers for Medicare & Medicaid Services?
The Stevan Ray Clark has been assigned the NPI (National Provider Identifier) 1376616227. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Stevan Ray Clark?
The Stevan Ray Clark is situated at 10220 S Western Ave, in the city of Los Angeles, state of CA, with the zip code 900474258.
What is the area of specialization for Stevan Ray Clark, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Stevan Ray Clark is Specialist, and the corresponding taxonomy code that categorizes this area of expertise is 174400000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1376616227 to Stevan Ray Clark?
The Centers for Medicare & Medicaid Services originally issued the 1376616227 to Stevan Ray Clark on 2006-11-16.
When was the information regarding Stevan Ray Clark most recently updated?
The details pertaining to the Stevan Ray Clark, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
NPI Number: 1528061710
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