Organization
IMAGE M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARENCE SUTTON M.D. (PHYSICIAN OWNER)
(818) 506-5906
Entity
Organization
Contact information
Practice address
12805 VICTORY BLVD, N HOLLYWOOD, CA 91606-3012
(818) 506-5906
Mailing address
12805 VICTORY BLVD, N HOLLYWOOD, CA 91606-3012
(818) 506-5906
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G74582
CA
Other
Enumeration date
01/16/2007
Last updated
08/22/2020
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