Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | GFE13004 | CA |
N | 207ND0900X | Dermatopathologist | GFE13004 | CA |
NPI | 1831444017 |
---|---|
Provider Name | Dr. John Arnot Clark |
First Address | Santa Barbara, CA 93103-1857 |
Second Address | Santa Barbara, CA 93103-1857 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2012 |
Last Update Date | 13/07/2012 |