Individual
MS. VIRLA BEATRICE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
30260 RANCHO VIEJO RD, SAN JUAN CAPISTRANO, CA 92675-1561
(949) 661-1700
Mailing address
30260 RANCHO VIEJO RD, SAN JUAN CAPISTRANO, CA 92675-1561
(949) 661-1700
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
723
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
723
CA
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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