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General NPI Number Information
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NPI Number | 1649309600
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Entity Type | Organization
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Legal Business Name | DONALD A. CLARKE, D.C., A CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 3840 WOODRUFF AVE SUITE NUMBER 201
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City | LONG BEACH
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State | CA
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Zip | 90808-2143
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Country | US
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Telephone | 562-421-8848
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Fax | 714-894-7009
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Provider Business Mailing Address
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Address Line | 13902 YANKTON WAY
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City | WESTMINSTER
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State | CA
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Zip | 92683-3420
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Country | US
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Telephone | 714-894-7009
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Fax | 714-894-7009
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD A. CLARKE
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Credential | D.C.
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Telephone | 562-421-8848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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