Individual
DR. CAMELLIA P. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4550 KEARNY VILLA RD STE 116, SAN DIEGO, CA 92123-1583
(858) 279-1223
Mailing address
4550 KEARNY VILLA RD STE 116, SAN DIEGO, CA 92123-1583
(858) 279-1223
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A052116
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004521160
—
CA
Enumeration date
09/26/2006
Last updated
03/25/2021
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