Individual
GLENN ALAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
207 W LEGION RD, BRAWLEY, CA 92227
(760) 351-3333
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA3696
CA
Other
Enumeration date
03/03/2008
Last updated
02/08/2019
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