Clark, Jesse Lawton
Clark, Jesse Lawton is an individual health care provider with primary practice located at 5767 W Century Blvd Suite 200, Los Angeles CA 90045-5632. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Clark, Jesse Lawton can be contacted via phone (310) 301-8708.Contact Information
Primary practice address
5767 W Century Blvd Suite 200
Los Angeles CA 90045-5632
Phone: (310) 301-8708
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A95103 | California |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | A95103 | California |
Profile Details
| NPI number | 1811166572 |
|---|---|
| LBN Legal business name | Clark, Jesse Lawton |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2008 |
| Last updated | Nov 7th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811166572 | NPPES |
| California | MEDICAID | 00A951030 |
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