Individual
GARY MICHAEL JESUS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHW
Contact information
Practice address
8151 ARLINGTON AVE STE U-V, RIVERSIDE, CA 92503-0436
(951) 688-3001
(951) 688-3022
Mailing address
8151 ARLINGTON AVE STE U-V, RIVERSIDE, CA 92503-0436
(951) 688-3001
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
CA
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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