Individual
COREY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
730 BAKER ST, SAN FRANCISCO, CA 94115-4305
(415) 567-1498
Mailing address
512 HEAD ST, SAN FRANCISCO, CA 94132-2823
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/20/2010
Last updated
07/20/2010
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