Individual
CLARK BRIXEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4094 4TH AVE., STE. 200, MAIL CODE: 0834, DEPT. OF RADIOLOGY BUSINESS OFFICE, UCSD, SAN DIEGO, CA 92103
(619) 543-7636
Mailing address
4097 CAMINITO TERVISO, SAN DIEGO, CA 92122-1991
(410) 218-5264
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101236649
VA
2085R0202X
Diagnostic Radiology Physician
Primary
C54415
CA
Other
Enumeration date
08/07/2006
Last updated
05/19/2011
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