Clark, Gregory D.

Clark, Gregory D. is an individual health care provider with primary practice located at 10666 N Torrey Pines Rd , La Jolla CA 92037-1027. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Clark, Gregory D. can be contacted via phone (858) 554-9946.

Contact Information

Primary practice address
10666 N Torrey Pines Rd La Jolla CA 92037-1027
Phone: (858) 554-9946
Fax: (858) 784-5933
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X E3359 California

Profile Details

NPI number 1285600098
LBN Legal business name Clark, Gregory D.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jul 24th, 2007 - about 19 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 1285600098 NPPES
California MEDICAID 000E33590

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