Healthcare Provider Details

I. General information

NPI: 1417819772
Provider Name (Legal Business Name): CLAYDON IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 CATHERINE LN
GRASS VALLEY CA
95945-5717
US

IV. Provider business mailing address

148 CATHERINE LN
GRASS VALLEY CA
95945-5717
US

V. Phone/Fax

Practice location:
  • Phone: 530-271-5879
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MARC CLAYDON
Title or Position: PODIATRIST/SURGEON
Credential: DPM
Phone: 530-271-5879