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General NPI Number Information
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NPI Number | 1942442066
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Entity Type | Organization
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Legal Business Name | CLEAR MEDICAL INC.
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 04/03/2009
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Provider Practice Location Address
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Address Line | 4560 ADMIRALTY WAY STE 200
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5425
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Country | US
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Telephone | 310-306-7100
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Fax | 301-306-7107
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Provider Business Mailing Address
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Address Line | 4560 ADMIRALTY WAY STE 200
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5425
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Country | US
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Telephone | 310-306-7100
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Fax | 301-306-7107
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Authorized Official
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Title or Position | OWNER
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Name | MR. SHAWN ABRISHAMY
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Credential | MD
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Telephone | 310-306-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | A85224
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A85245
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License Number State | CA
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