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Dr. Stevan Ray Clark, MD
Specialist in Los Angeles, California
NPI 1376616227

Stevan Ray Clark is a Specialist based in Los Angeles, CA. Stevan Ray Clark practices in Los Angeles, CA and has the professional credentials of MD. The NPI Number for Stevan Ray Clark is 1376616227 and holds a License No. G63102 (California).

The current practice location address for Stevan Ray Clark is 10220 S Western Ave, Los Angeles, CA and can be reached out via phone at 323-757-1744 and via fax at 323-757-3818.

Location: 10220 S Western Ave, Los Angeles, CA, 90047-4258
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376616227
Provider Name
Stevan Ray Clark
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
10220 S Western Ave, Los Angeles, CA, 90047-4258
Phone Number
323-757-1744
Fax Number
323-757-3818
Provider Enumeration Date
11/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00G631020 05 CA
institution
Provider Business Practice Location Address Details
Address
10220 S Western Ave
City
Los Angeles
State
California
Zip
90047-4258
Phone Number
323-757-1744
Fax Number
323-757-3818
person
Provider Business Mailing Address Details
Address
10220 S Western Ave
City
Los Angeles
State
California
Zip
90047-4258
Phone Number
323-757-1744
Fax Number
323-757-3818
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
G63102 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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