Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 47916 | KY |
N | 207Q00000X | Family Doctor | A148861 | CA |
N | 207Q00000X | Family Doctor | ME 124874 | FL |
Y | 207QA0401X | Family Doctor - Addiction Medicine | A148861 | CA |
N | 207QA0401X | Family Doctor - Addiction Medicine | ME124874 | FL |
NPI | 1154680668 |
---|---|
Provider Name | Dr. Brian Robert Clear |
First Address | Oakland, CA 94607-1341 |
Second Address | Boston, MA 02111-1929 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2012 |
Last Update Date | 19/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016297400 | (05) | FL |
800667750 | (05) | CA |