Individual provider · NPI-1

Craig Anson Clark, PA-C

Preventive Medicine, Occupational Medicine · Riverside, CA

NPI number1952015802
StatusActive
Last updated in NPPESJan 5, 2023

Details

NPI
1952015802
Entity type
Individual (NPI-1)
Name
Mr. Craig Anson Clark
Credential
PA-C
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 5, 2023
Certification date
Jan 5, 2023
Last updated
Jan 5, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2083X0100X Preventive Medicine, Occupational Medicine10026CAYes

Practice location

3579 Arlington Ave Ste 300
Riverside, CA 92506-3915

Phone 951-341-9333 · Fax 951-341-9330

Mailing address

5911 Grinnell Dr
Jurupa Valley, CA 92509-7046

Phone 951-733-4650

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