Healthcare Provider Details

I. General information

NPI: 1871429787
Provider Name (Legal Business Name): ELIZABETH CLARK, MD, MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 MAJOR SHERMAN LN STE 300
MONTEREY CA
93940-4644
US

IV. Provider business mailing address

910 MAJOR SHERMAN LN STE 300
MONTEREY CA
93940-4644
US

V. Phone/Fax

Practice location:
  • Phone: 831-230-3960
  • Fax:
Mailing address:
  • Phone: 831-230-3960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH CLARK
Title or Position: OWNER
Credential: MD
Phone: 831-230-3805