Individual provider · Type 1 NPI
Paul Ray Clark, MD
Plastic and Reconstructive Surgery Physician · San Diego, CA
NPI number
1619362597
Active
Practice location
11515 El Camino Real Ste 150
San Diego, CA 92130-3037
Mailing address
6431 Fannin St, Msb 4.331
Houston, TX 77030-1501
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Plastic and Reconstructive Surgery Physician Primary | 2086S0122X | A18267 (CA) |
Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.
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About NPI 1619362597
Paul Ray Clark, MD's National Provider Identifier is 1619362597, issued on Mar 30, 2015. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in San Diego, CA. The record was last updated on Mar 5, 2024.