Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC11981 | CA |
NPI | 1457422560 |
---|---|
Provider Name | Dr. Patrick Vincent Mcclure |
First Address | Oakhurst, CA 93644-8844 |
Second Address | Oakhurst, CA 93644-8844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2006 |
Last Update Date | 08/07/2007 |