Clark, Eric Leonard

Clark, Eric Leonard is an individual health care provider with primary practice located at 3626 Ruffin Rd , San Diego CA 92123-1810. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Clark, Eric Leonard can be contacted via phone (858) 565-9666.

Contact Information

Primary practice address
3626 Ruffin Rd San Diego CA 92123-1810
Phone: (858) 565-9666
Fax: (858) 565-9441
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X G65721 California

Profile Details

NPI number 1720078470
LBN Legal business name Clark, Eric Leonard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Apr 14th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720078470 NPPES
California MEDICAID 1720078470
California MEDICAID 00G657210

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