Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | G89379 | CA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | MD00024397 | WA |
N | 2081S0010X | Sports Medicine | MD00024397 | WA |
N | 213ES0000X | Sports Medicine | MD00024397 | WA |
NPI | 1184805905 |
---|---|
Provider Name | David R Clawson |
First Address | Rancho Mirage, CA 92270-3221 |
Second Address | Rancho Mirage, CA 92270-3221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2007 |
Last Update Date | 03/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1184805905 | (05) | WA |
E32560 | (02) | CA |