Individual
CYNTHIA BILLMEYER CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4000 CIVIC CENTER DR, SAN RAFAEL, CA 94903-4171
(209) 342-2300
(209) 524-4240
Mailing address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G53191
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G531910
BCBS
CA
05
—
00G531910
—
CA
Enumeration date
10/17/2005
Last updated
07/08/2007
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