Individual
JOHN CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15630 18TH AVE, CLEARLAKE, CA 95422
(707) 994-6486
Mailing address
1750 WESTLAKE DR, KELSEYVILLE, CA 95451-7049
(707) 994-6486
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
NA1636
CA
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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