Provider Demographics
NPI:1548460603
Name:CLAPPER, MARK F (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:F
Last Name:CLAPPER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:393 E WALNUT ST
Mailing Address - Street 2:3RD FLOOR - PHR SYSTEMS
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91188-0001
Mailing Address - Country:US
Mailing Address - Phone:626-405-7914
Mailing Address - Fax:626-405-6768
Practice Address - Street 1:4405 VANDEVER AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-3315
Practice Address - Country:US
Practice Address - Phone:619-528-5000
Practice Address - Fax:626-405-6768
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2021-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG59619204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G596190OtherMEDICAL PIN
CAF47313Medicare UPIN