Individual
DR. CLARK STUART PADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23962 ALICIA PKWY, SUITE I1, MISSION VIEJO, CA 92691-3940
(949) 452-7699
Mailing address
1904 N HELIOTROPE DR, SANTA ANA, CA 92706-2538
(714) 624-0772
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A51251
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A512510
—
CA
Enumeration date
07/03/2006
Last updated
04/23/2014
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