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1376751917
MICHAEL CLARK
SAN DIEGO, CA
NPI
1376751917
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2007-05-18
Last Update Date
2008-02-01
Business Address
-- MICHAEL CLARK
140 SYLVESTER RD
SAN DIEGO, CA 92106-3521
Phone number: 619-553-8719
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Mailing Address
-- MICHAEL CLARK
25106 CORN FIELD CT
MENIFEE, CA 92584-8562
Phone number: 951-679-3324
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