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DOLPHE SCOTT CLARK M.D.
>> Surgery >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1245412303
Individual Registrant: DOLPHE SCOTT CLARK M.D.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
152 PIONEER LN STE G BISHOP, CA 93514-2563 US
Tel: 760-872-2244 Fax: 760-872-2245
Tel: 760-872-2244 Fax: 760-872-2245
Contact information for business:
152 PIONEER LN STE G BISHOP, CA 93514-2563 US
Tel: 760-872-2244 Fax: 760-872-2245
Tel: 760-872-2244 Fax: 760-872-2245
Registration Information:
NPI: 1245412303
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 208600000X | Allopathic & Osteopathic Physicians Surgery | CA | C27196 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 00C271960 | CA | 05 |
