Individual
DR. TIMOTHY VAUGHAN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
726 4TH ST, MARYSVILLE, CA 95901-5656
(530) 743-4377
(530) 749-6616
Mailing address
PO BOX 3067, YUBA CITY, CA 95992-3067
(207) 939-4204
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OTO13674
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
20A13845
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A13845
LICENSE
CA
Enumeration date
06/20/2010
Last updated
02/24/2016
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