Individual
ANTONIA MALIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7901 FROST ST, SAN DIEGO, CA 92123-2701
(858) 939-3400
Mailing address
285 MANZANITA DR, OCEANSIDE, CA 92057-5405
(619) 621-9545
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
95191828
CA
Other
Enumeration date
04/28/2023
Last updated
04/28/2023
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