Individual provider · Type 1 NPI

Davin Wilson Chark, MD

Student in an Organized Health Care Education/Training Program · Orange, CA

NPI number 1790938306 Active

Practice location

101 The City Dr S, Bldg 56, Ste 500
Orange, CA 92868-3201

Call (714) 456-5753 Map

Fax (714) 456-5747

Mailing address

12151 Bayport St, APT.# 10-208
Garden Grove, CA 92840-4471

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1790938306

Davin Wilson Chark, MD's National Provider Identifier is 1790938306, issued on Oct 28, 2008. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Orange, CA. The record was last updated on Oct 28, 2008.