Individual provider · Type 1 NPI

Stevan Ray Clark, MD

Specialist · Los Angeles, CA

NPI number 1376616227 Active

Practice location

10220 S Western Ave
Los Angeles, CA 90047-4258

Call (323) 757-1744 Map

Fax (323) 757-3818

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XG63102 (CA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1376616227

Stevan Ray Clark, MD's National Provider Identifier is 1376616227, issued on Nov 16, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Los Angeles, CA. The record was last updated on Jul 8, 2007.