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Steven Jon Clark, DPM
Foot & Ankle Surgery Podiatrist in Nipomo, California
NPI 1114952462

Steven Jon Clark is a Foot & Ankle Surgery Podiatrist based in Nipomo, CA and is specialized in Foot & Ankle Surgery. Steven Jon Clark practices in Nipomo, CA and has the professional credentials of DPM. The NPI Number for Steven Jon Clark is 1114952462 and holds a License No. E4336 (California).

The current practice location address for Steven Jon Clark is 699 W Tefft St Ste A, Nipomo, CA and can be reached out via phone at 805-619-5610 and via fax at 805-619-5179.

Location: 699 W Tefft St Ste A, Nipomo, CA, 93444-9288
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114952462
Provider Name
Steven Jon Clark
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
699 W Tefft St Ste A, Nipomo, CA, 93444-9288
Phone Number
805-619-5610
Fax Number
805-619-5179
Provider Enumeration Date
07/12/2006
Last Update Date
07/20/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000E43360 05 CA
institution
Provider Business Practice Location Address Details
Address
699 W Tefft St Ste A
City
Nipomo
State
California
Zip
93444-9288
Phone Number
805-619-5610
Fax Number
805-619-5179
person
Provider Business Mailing Address Details
Address
699 W Tefft St Ste A
City
Nipomo
State
California
Zip
93444-9288
Phone Number
805-619-5610
Fax Number
805-619-5179
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
E4336 (California)
Definition
Definition to come...
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