Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | G59619 | CA |
NPI | 1548460603 |
---|---|
Provider Name | Mark F Clapper |
First Address | Pasadena, CA 91188-0001 |
Second Address | San Diego, CA 92120-3315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2007 |
Last Update Date | 29/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G596190 | MEDICAL PIN (01) | CA |
F47313 | (02) | CA |