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Clinton Russell Stark, DC
Chiropractor in Tustin, California
NPI 1124184593

Clinton Russell Stark is a Chiropractor based in Tustin, CA. Clinton Russell Stark practices in Tustin, CA and has the professional credentials of DC. The NPI Number for Clinton Russell Stark is 1124184593 and holds a License No. DC24623 (California).

The current practice location address for Clinton Russell Stark is 13771 Newport Ave, Tustin, CA and can be reached out via phone at 714-368-7600 and via fax at 714-368-7630.

Location: 13771 Newport Ave, Tustin, CA, 92780-4693
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1124184593
Provider Name
Clinton Russell Stark
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
13771 Newport Ave, Tustin, CA, 92780-4693
Phone Number
714-368-7600
Fax Number
714-368-7630
Provider Enumeration Date
12/29/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
54220DC0246230 01 CA BLUE SHIELD OF CALIFORNIA
institution
Provider Business Practice Location Address Details
Address
13771 Newport Ave
City
Tustin
State
California
Zip
92780-4693
Phone Number
714-368-7600
Fax Number
714-368-7630
person
Provider Business Mailing Address Details
Address
13771 Newport Ave
City
Tustin
State
California
Zip
92780-4693
Phone Number
714-368-7600
Fax Number
714-368-7630
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
DC24623 (California)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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