Kerry R Clark, MD | |
25751 Mcbean Pkwy, Ste 210, Valencia, CA 91355-3701 | |
(661) 284-3100 | |
(661) 290-3310 |
Full Name | Kerry R Clark |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 25751 Mcbean Pkwy, Valencia, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093802365 | NPI | - | NPPES |
00G771370 | Other | CA | BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | G60150 (California) | Primary |
Entity Name | Northeast Valley Health Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629079009 PECOS PAC ID: 3173517323 Enrollment ID: O20040412001067 |
Mailing Address | Practice Location Address |
---|---|
Kerry R Clark, MD 23388 Mulholland Dr, Mailstop 62, Woodland Hills, CA 91364-2733 Ph: (818) 876-1636 | Kerry R Clark, MD 25751 Mcbean Pkwy, Ste 210, Valencia, CA 91355-3701 Ph: (661) 284-3100 |
Mostafa Tabassomi, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 23838 Valencia Blvd Ste 304, Valencia, CA 91355 Phone: 661-430-9030 Fax: 661-430-9020 | |
Dr. Gene L Tran, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 23803 Mcbean Pkwy, Valencia, CA 91355 Phone: 661-481-2400 | |
Dr. Robert Kozlowski, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 25751 Mcbean Pkwy Ste 210, Valencia, CA 91355 Phone: 661-284-3100 Fax: 661-290-3310 | |
Dr. Douglas R Gadowski, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 25775 Mcbean Pkwy, Ste 105, Valencia, CA 91355 Phone: 661-255-2410 Fax: 661-255-8671 | |
Sittiporn Bencharit, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 25775 Mcbean Pkwy, Suite 115, Valencia, CA 91355 Phone: 661-255-2420 Fax: 661-259-0552 | |
David Elliott Krieger, M.D.,PH.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 25775 Mcbean Pkwy, Suite 115, Valencia, CA 91355 Phone: 661-255-2420 Fax: 661-259-5741 | |
Arousha Davatgarzadeh, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 26357 Mcbean Pkwy, Valencia, CA 91355 Phone: 661-222-2605 Fax: 661-222-2694 |