Clark, Larry Dean
Clark, Larry Dean is an sole proprietor health care provider with primary practice located at 811 Grand Ave , Sacramento CA 95838-3466. He recently has only one registered license in Other Service Providers / Contractor, which is considered as his primary health care specialty. Clark, Larry Dean can be contacted via phone (916) 922-9868.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Contractor | 171W00000X |
Profile Details
| NPI number | 1578263117 |
|---|---|
| LBN Legal business name | Clark, Larry Dean |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 2nd, 2023 |
| Last updated | Mar 2nd, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578263117 | NPPES |
| California | MEDICAID | 0 |
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