Clos, Autumn Patricia

Clos, Autumn Patricia is an individual health care provider with primary practice located at 33353 Yucaipa Blvd , Yucaipa CA 92399. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Clos, Autumn Patricia can be contacted via phone (909) 790-7900.

Contact Information

Primary practice address
33353 Yucaipa Blvd Yucaipa CA 92399
Phone: (909) 790-7900
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X C54711 California
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01078576A Indiana

Profile Details

NPI number 1730285123
LBN Legal business name Clos, Autumn Patricia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Sep 4th, 2018 - about 8 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 1730285123 NPPES
Other 1730285123 NPI
MEDICAID 300002637 NPI
Other 1730285123 NPI

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