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Organization
WEST COAST PRIMARY CARE MEDICAL GROUP
Active
Organization
WEST COAST PRIMARY CARE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS G CLARK (OWNER/PRESIDENT)
(714) 530-7373
Entity
Organization
Contact information
Practice address
12665 GARDEN GROVE BLVD, SUITE 301, GARDEN GROVE, CA 92843-1901
(714) 530-7373
(714) 530-7940
Mailing address
12665 GARDEN GROVE BLVD, SUITE 301, GARDEN GROVE, CA 92843-1901
(714) 530-7373
(714) 530-7940
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/11/2007
Last updated
09/14/2007
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