Clark, Isaiah Daniel

Clark, Isaiah Daniel is an sole proprietor health care provider with primary practice located at 19510 Van Buren Blvd # F3-1045 , Riverside CA 92508-9457. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Health Educator, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Clinical Exercise Physiologist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Clinical Exercise Physiologist is his primary health care specialty. Clark, Isaiah Daniel can be contacted via phone (951) 215-6829.

Contact Information

Primary practice address
19510 Van Buren Blvd # F3-1045 Riverside CA 92508-9457
Phone: (951) 215-6829
Fax: (951) 246-0734
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Health Educator 174H00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Clinical Exercise Physiologist 224Y00000X 1066261 California

Profile Details

NPI number 1861092447
LBN Legal business name Clark, Isaiah Daniel
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2020
Last updated Aug 2nd, 2021 - about 4 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 1861092447 NPPES
California Other 872340 AMERICAN COLLEGE OF SPORTS MEDICINE

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