Organization
THOMAS J CLARK DO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JOSEPH CLARK D.O. (PRESIDENT)
(805) 547-2275
Entity
Organization
Contact information
Practice address
620 CALIFORNIA BLVD., SUITE J, SAN LUIS OBISPO, CA 93401-2598
(805) 547-2275
(805) 547-2279
Mailing address
620 CALIFORNIA BLVD., SUITE J, SAN LUIS OBISPO, CA 93401-2598
(805) 547-2275
(805) 547-2279
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
20A8621
CA
261QM2500X
Medical Specialty Clinic/Center
20A8621
CA
Other
Enumeration date
01/04/2007
Last updated
03/05/2009
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