Organization
CLARKE NEUROLOGY A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERYN BREE CLARKE M.D. (PRESIDENT)
(949) 701-2811
Entity
Organization
Contact information
Practice address
400 NEWPORT CENTER DR, STE 310, NEWPORT BEACH, CA 92660-7601
(949) 701-2811
Mailing address
400 NEWPORT CENTER DR, STE 310, NEWPORT BEACH, CA 92660-7601
(949) 701-2811
(949) 644-1911
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
A72641
CA
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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