Clark, Theresa Ross
Clark, Theresa Ross is an individual health care provider with primary practice located at 2067 W Vista Way Suite 200, Vista CA 92083-6031. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Clark, Theresa Ross can be contacted via phone (760) 726-2180.Contact Information
Primary practice address
2067 W Vista Way Suite 200
Vista CA 92083-6031
Phone: (760) 726-2180
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 24637 | Nebraska |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A110524 | California |
Profile Details
| NPI number | 1528104650 |
|---|---|
| LBN Legal business name | Clark, Theresa Ross |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Sep 5th, 2012 - about 14 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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