Richard Wayne Clark
Otolaryngologist (ENT Doctor)
1245 Wilshire Blvd
Los Angeles
, California 90017-4810
Richard Wayne Clark
Otolaryngologist (ENT Doctor)
1245 Wilshire Blvd
Los Angeles
, California 90017-4810
(213) 977-0404
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
Languages spoken
- English
Location
First Address
- Richard Wayne Clark
- 1245 Wilshire Blvd
- Los Angeles, CA
- Zip : 90017-4806
- Fax : (213) 977-0404
- Phone : (213) 977-1215
Second Address
- Richard Wayne Clark
- 1245 Wilshire Blvd
- Los Angeles, CA
- Zip : 90017-4810
- Fax : (213) 977-0404
- Phone : (213) 977-1215
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G23111 | CA |
National Provider Identifier
| NPI | 1073554242 |
|---|---|
| Provider Name | Richard Wayne Clark |
| First Address | Los Angeles, CA 90017-4806 |
| Second Address | Los Angeles, CA 90017-4810 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/06/2006 |
| Last Update Date | 06/07/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| A41858 | (02) | CA |
| GR0071560 | (05) | CA |
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.