Individual provider · Type 1 NPI
Tatianna Clark
Medical Physician Assistant · Riverside, CA
NPI number
1104692144
Active
Practice location
3940 Polk St Unit A
Riverside, CA 92505-1998
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 63689 (CA) |
Medical Physician Assistant: Definition to come...
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About NPI 1104692144
Tatianna Clark's National Provider Identifier is 1104692144, issued on Nov 30, 2023. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Riverside, CA. The record was last updated on Nov 30, 2023.