Individual
CLARENCE SUTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
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
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G74582
LICENSE
CA
Enumeration date
01/12/2007
Last updated
07/08/2007
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