Clark, Russell

Clark, Russell is an sole proprietor health care provider with primary practice located at 1412 Liatris Way , Beaumont CA 92223-8468. He recently has only one registered license in Hospitals / General Acute Care Hospital, which is considered as his primary health care specialty. Clark, Russell can be contacted via phone (951) 769-1241.

Contact Information

Primary practice address
1412 Liatris Way Beaumont CA 92223-8468
Phone: (951) 769-1241
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Hospitals / General Acute Care Hospital 282N00000X 515669CA California

Profile Details

NPI number 1952554420
LBN Legal business name Clark, Russell
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 28th, 2008
Last updated Oct 28th, 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.

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