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MR. JOHN CLARK RN
General Practice >> Registered Nurse >> Nursing Service ProvidersRegistrant NPI Number: 1689728032
Individual Registrant:MR. JOHN CLARK RN
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
52 N TU SU LN BISHOP, CA 93514-8058 US
Tel: 760-873-8461 Fax: 760-873-3530
Tel: 760-873-8461 Fax: 760-873-3530
Contact information for business:
RR 2 BOX 24R BISHOP, CA 93514-9610 US
Tel: 760-387-2187 Fax: --
Tel: 760-387-2187 Fax: --
Registration Information:
NPI: 1689728032
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 163WG0000X | Nursing Service Providers Registered Nurse General Practice | CA | RN629103 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| ORGANIZATION NPI # | 1659433191 | CA | 01 |
