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Tatianna Clark
Medical Physician Assistant in Riverside, California
NPI 1104692144

Tatianna Clark is a Medical Physician Assistant based in Riverside, CA and is specialized in Medical. Tatianna Clark practices in Riverside, CA. The NPI Number for Tatianna Clark is 1104692144 and holds a License No. 63689 (California).

The current practice location address for Tatianna Clark is 3940 Polk St Unit A, Riverside, CA and can be reached out via phone at 818-632-4265.

Location: 3940 Polk St Unit A, Riverside, CA, 92505-1998
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Provider Profile Details
NPI Number
1104692144
Provider Name
Tatianna Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
3940 Polk St Unit A, Riverside, CA, 92505-1998
Phone Number
818-632-4265
Fax Number
Provider Enumeration Date
11/30/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3940 Polk St Unit A
City
State
Zip
92505-1998
Phone Number
818-632-4265
Fax Number
person
Provider Business Mailing Address Details
Address
3940 Polk St Unit A
City
State
Zip
92505-1998
Phone Number
818-632-4265
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
63689 (California)
Definition
Definition to come...
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