Individual
CLARK LARKIN GIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7117 BROCKTON AVE, RIVERSIDE, CA 92506-2615
(951) 782-3685
(951) 784-3256
Mailing address
3660 ARLINGTON AVE, RIVERSIDE, CA 92506-3912
(951) 782-3685
(951) 784-3256
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G47524
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730180415
GROUP NPI NUMBER
—
01
—
ZZZ31887Z
GROUP SITE NUMBER
—
Enumeration date
11/10/2005
Last updated
12/02/2011
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