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General NPI Number Information
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NPI Number | 1508762659
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Entity Type | Organization
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Legal Business Name | ALEJANDRA CLARK MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/15/2026
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Last Update Date | 10/15/2026
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Provider Practice Location Address
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Address Line | 820 N MOUNTAIN AVE STE 108
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City | UPLAND
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State | CA
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Zip | 91786-4163
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Country | US
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Telephone | 909-256-4175
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Fax |
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Provider Business Mailing Address
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Address Line | 820 N MOUNTAIN AVE STE 108
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City | UPLAND
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State | CA
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Zip | 91786-4163
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Country | US
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Telephone | 909-256-4175
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEJANDRA CLARK
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Credential | MD
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Telephone | 909-256-4175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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