Justin S Clark
General Practice Physician
200 Mercy Cir Dept Of Radiology
Oceanside
, California 92055-5191
Justin S Clark
General Practice Physician
200 Mercy Cir Dept Of Radiology
Oceanside
, California 92055-5191
(619) 565-5588
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Justin S Clark
- 2051 San Remo Dr
- Oceanside, CA
- Zip : 92056-3282
- Phone : (619) 565-5588
Second Address
- Justin S Clark
- 200 Mercy Cir Dept Of Radiology
- Oceanside, CA
- Zip : 92055-5191
- Phone : (760) 719-3478
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208D00000X | General Practice Physician | 51149-20 | WI |
National Provider Identifier
| NPI | 1033146634 |
|---|---|
| Provider Name | Justin S Clark |
| First Address | Oceanside, CA 92056-3282 |
| Second Address | Oceanside, CA 92055-5191 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/06/2006 |
| Last Update Date | 20/05/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.