Individual
GREGORY D. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
10666 N TORREY PINES RD, LA JOLLA, CA 92037-1027
(858) 554-9946
(858) 784-5933
Mailing address
FILE# 54433, LOS ANGELES, CA 90074-0001
(858) 784-5906
(858) 784-5933
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3359
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E33590
—
CA
Enumeration date
02/23/2006
Last updated
07/24/2007
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