Individual
LARRY ANDREW CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
435 N ROXBURY DR, STE 100, BEVERLY HILLS, CA 90210-5027
(310) 855-8058
(310) 855-8059
Mailing address
435 N ROXBURY DR, STE 100, BEVERLY HILLS, CA 90210-5027
(310) 855-8058
(310) 855-8059
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
124156
CA
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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