Individual provider · Type 1 NPI
Mariam Clark, NP
Family Nurse Practitioner · Los Angeles, CA
NPI number
1619370194
Active
Practice location
3612 1/2 E 1st St
Los Angeles, CA 90063-2326
Mailing address
6551 Harrington Ct
Chino, CA 91710-7376
Other practice locations
- 6551 Harrington Ct, Chino, CA 91710-7376 · (909) 613-9238
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F0714462 (CA) |
| Family Nurse Practitioner Primary | 363LF0000X | 95000880 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1619370194
Mariam Clark, NP's National Provider Identifier is 1619370194, issued on Sep 29, 2014. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Los Angeles, CA. The record was last updated on Mar 14, 2022.