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Individual

ALLEN O CLYDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
688 MEDICAL CENTER DR E, SUITE 106, CLOVIS, CA 93611-6807
(559) 297-8604
(559) 297-0625
Mailing address
688 MEDICAL CENTER DR E, SUITE 106, CLOVIS, CA 93611-6807
(559) 297-8604
(559) 297-0625

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E1976
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E19760
CA
01
946424550
TAX ID
CA
01
E1976
PODIATRIC MEDICINE
CA
01
E19760
CALIFORNIA LICENSE
CA
Enumeration date
02/26/2007
Last updated
03/07/2023
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