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Individual

ISAIAH DANIEL CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
19510 VAN BUREN BLVD # F3-1045, RIVERSIDE, CA 92508-9457
(951) 215-6829
(951) 246-0734
Mailing address
22376 N MULLIGAN DR, MARICOPA, AZ 85138-2353

Taxonomy

Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
1066261
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
872340
AMERICAN COLLEGE OF SPORTS MEDICINE
CA
Enumeration date
10/31/2020
Last updated
06/03/2025
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