Clark, Bliss Watson

Clark, Bliss Watson is an individual health care provider with primary practice located at 1262 E North St , Manteca CA 95336-4962. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Clark, Bliss Watson can be contacted via phone (209) 214-7053.

Contact Information

Primary practice address
1262 E North St Manteca CA 95336-4962
Phone: (209) 214-7053
Fax: (209) 523-0764
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X G59282 California

Profile Details

NPI number 1447258272
LBN Legal business name Clark, Bliss Watson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Nov 5th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447258272 NPPES
Texas MEDICAID 033099502

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