Individual
BRYAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1500 21ST ST, SACRAMENTO, CA 95811-5216
(916) 443-3299
Mailing address
2620 Q ST APT 1, SACRAMENTO, CA 95816-6929
(831) 236-6468
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
11/10/2022
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