Organization
LOS ANGELES EAR, NOSE & THROAT ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD W CLARK M.D. (PARTNER)
(213) 977-1215
Entity
Organization
Contact information
Practice address
1245 WILSHIRE BLVD, SUITE 603, LOS ANGELES, CA 90017-4810
(213) 977-1215
(213) 977-0404
Mailing address
1245 WILSHIRE BLVD, SUITE 603, LOS ANGELES, CA 90017-4810
(213) 977-1215
(213) 977-0404
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0071560
—
CA
Enumeration date
06/04/2006
Last updated
07/06/2011
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