Adam Bradley Clark, DO
Family Medicine in Simi Valley, CA. Individual provider (NPI-1).
NPI number1861865610
StatusActive
Last updated in NPPESJun 28, 2024
Details
- NPI
- 1861865610
- Entity type
- Individual (NPI-1)
- Name
- Adam Bradley Clark
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 2, 2015
- Certification date
- Jun 28, 2024
- Last updated
- Jun 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | A16957 | CA | Yes |
| 208M00000X | Hospitalist | A16957 | CA | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
2876 Sycamore Dr Ste 101Simi Valley, CA 93065-1550
Phone 805-527-0115 · Fax 805-522-0115
Mailing address
2876 Sycamore Dr Ste 101Simi Valley, CA 93065-1550
Phone 805-527-0115 · Fax 805-522-0115
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