| Thomas J Clark Do Inc | |
|
620 California Blvd. Suite J San Luis Obispo CA 93401-2598 | |
| (805) 547-2275 | |
| (805) 547-2279 |
| Full Name | Thomas J Clark Do Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 620 California Blvd., San Luis Obispo, California |
| Authorized Official Name and Position | Thomas Joseph Clark (PRESIDENT) |
| Authorized Official Contact | 8055472275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas J Clark Do Inc 620 California Blvd. Suite J San Luis Obispo CA 93401-2598 Ph: (805) 547-2275 | Thomas J Clark Do Inc 620 California Blvd. Suite J San Luis Obispo CA 93401-2598 Ph: (805) 547-2275 |
| NPI Number | 1669529582 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 03/05/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669529582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 20A8621 (California) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | 20A8621 (California) | Secondary |
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