Individual
RAMONA R CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G9685
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G96850
BLUE SHIELD OF CA
CA
05
—
00G96850
—
CA
01
—
WG9685
RR MC
CA
Enumeration date
05/18/2006
Last updated
10/18/2007
Update your record
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