Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 24950 | TX |
Y | 213EG0000X | General Practice | 24950 | TX |
NPI | 1003047333 |
---|---|
Provider Name | Dr. Clayton Rau |
First Address | San Diego, CA 92134-0001 |
Second Address | San Diego, CA 92134-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2009 |
Last Update Date | 27/04/2021 |