Individual
ELLEN MARGARET CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3600 BROADWAY LOWR LEVEL, OAKLAND, CA 94611-5730
(510) 752-5991
Mailing address
3600 BROADWAY LOWR LEVEL, OAKLAND, CA 94611-5730
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
20A23964
CA
2085R0202X
Diagnostic Radiology Physician
Primary
20A23964
CA
Other
Enumeration date
03/21/2019
Last updated
08/04/2025
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