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Contact Information

LARRY A CLARK
435 N ROXBURY DR
STE 100
BEVERLY HILLS, CA90210-5027
 Phone: 310-855-8058
 Fax: 310-855-8059
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Assistant

246ZC0007X
Indicates primary specialty

NPI Profile & details for LARRY A CLARK · (Male)

NPI # 1174884456
Status Active
Credentials
Entity Individual
Enumeration date 06/04/2012
Last updated 06/04/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 124156
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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