DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MR. MITCHELL BRADY CLARK M.S.

MEDICARE: MR. MITCHELL BRADY CLARK M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101YM0800XMental Health CounselorRC00050738WA

General Provider Information

NPI Number : 1578798278
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MITCHELL BRADY CLARK M.S.
Provider Business Mailing Address
First Line : 6160 MISSION GORGE RD STE 120
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-3425
Country : US
Telephone Number : 619-282-2232
Fax Number : 619-282-2992
Provider Business Practice Location Address
First Line : 6160 MISSION GORGE RD STE 120
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-3425
Country : US
Telephone Number : 619-282-2232
Fax Number : 619-282-2992
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2009
Last Update Date : 09/24/2024

Similar Medicare Providers

1205767670 — KNARA ARUTIUNIAN
Practice Location Address:
6160 MISSION GORGE RD STE 100
SAN DIEGO, CA
92120-3425
Practice Phone: 619-481-3790
Practice Fax: 619-481-3797
1275464646 — GEORGE ANTOINE BUCHANAN JR.
Practice Location Address:
6160 MISSION GORGE RD STE 100
SAN DIEGO, CA
92120-3425
Practice Phone: 619-481-3790
Practice Fax: 619-481-3797
1548007412 — KEILANI VELASCO
Practice Location Address:
6160 MISSION GORGE RD STE 100
SAN DIEGO, CA
92120-3425
Practice Phone: 619-481-3790
Practice Fax: 619-481-3797
1588516561 — JAIRO OSCAR HERNANDEZ CAMACHO
Practice Location Address:
6160 MISSION GORGE RD STE 100
SAN DIEGO, CA
92120-3425
Practice Phone: 619-481-3790
Practice Fax: 619-481-3797
1760289359 — GENESIS SOLORIO
Practice Location Address:
6160 MISSION GORGE RD STE 100
SAN DIEGO, CA
92120-3425
Practice Phone: 619-481-3790
Practice Fax: 619-481-3797
1417885328 — MATTHEW MINIHAN
Practice Location Address:
6160 MISSION GORGE RD STE 100
SAN DIEGO, CA
92120-3425
Practice Phone: 619-481-3790
Practice Fax: 619-481-3797

Directions to “ MR. MITCHELL BRADY CLARK M.S.” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.