Individual
MICHAEL S. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 SERENO DR, VALLEJO, CA 94589-2441
(707) 651-1000
Mailing address
1800 HARRISON ST FL 7, OAKLAND, CA 94612-3429
(510) 625-6262
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
C36902
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C369020
—
CA
Enumeration date
11/01/2006
Last updated
07/08/2007
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