Individual
MR. ETHAN M CLAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
23000 ATLANTIC CIRCLE, MORENO VALLEY, CA 92553-5229
(951) 924-1877
(951) 485-3580
Mailing address
23000 ATLANTIC CIR, MORENO VALLEY, CA 92553-5990
(951) 924-1877
(951) 485-3580
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12701T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0093410
—
CA
Enumeration date
12/13/2006
Last updated
01/18/2013
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