Clark, Ma.Belen S.

Clark, Ma.Belen S. is an sole proprietor health care provider with primary practice located at 1954 Via Ctr Ste B , Vista CA 92081-6056. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Clark, Ma.Belen S. can be contacted via phone (760) 529-9700.

Contact Information

Primary practice address
1954 Via Ctr Ste B Vista CA 92081-6056
Phone: (760) 529-9700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036-104581 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2004025497 Missouri
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A100202 California

Profile Details

NPI number 1194791178
LBN Legal business name Clark, Ma.Belen S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 28th, 2006
Last updated May 10th, 2024 - about 6 months 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 1194791178 NPPES
Missouri MEDICAID 209071109
Missouri Other EG9762

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