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General NPI Number Information
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NPI Number | 1528315835
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Entity Type | Individual
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Provider Name | MATTHEW E.A. CLARKE MD
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Gender | Male
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 1868 PACIFIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90806-6113
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Country | US
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Telephone | 562-595-4718
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Fax | 562-591-7323
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Provider Business Mailing Address
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Address Line | 24200 WALNUT ST SPC 108
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City | TORRANCE
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State | CA
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Zip | 90501-6737
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Country | US
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Telephone | 424-653-9547
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | A134249
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A134249
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License Number State | CA
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