Organization
CLARK PEDIATRICS AND FAMILY MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEATHER MAILE TOMLIN (BILLING MANAGER)
(949) 458-7736
Entity
Organization
Contact information
Practice address
15 MAREBLU, SUITE 340, ALISO VIEJO, CA 92656-3015
(949) 831-1466
(949) 831-1462
Mailing address
15 MAREBLU, SUITE 340, ALISO VIEJO, CA 92656-3015
(949) 831-1466
(949) 831-1462
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A18257
CA
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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