Lance R. Clawson, C.P.O.
Individual provider Active NPI Prosthetist · Pomona, CA
NPI 1497913719 · NPPES record last updated May 23, 2008
Key facts
- NPI
- 1497913719
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthetist 224P00000X
- License
- CPO01251 (CA)
- Practice address
- 320 E Bonita Ave
Pomona, CA 91767-1926 - Phone
- (909) 621-1180
- Fax
- (909) 624-1650
- NPI assigned
- May 23, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPO01251 | CA | MD | Prosthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J&K Orthopedics Inc | Orthotist | Past | Accepting new patients |
| J&K Orthopedics Inc | Orthotist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | CPO01251 | CA | |
| Prosthetist | 224P00000X | CPO01251 | CA | Yes |
Addresses
Primary practice location
320 E Bonita Ave
Pomona, CA 91767-1926
Mailing address
320 E Bonita Ave
Pomona, CA 91767-1926
Phone (909) 621-1180
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GXC000770 | Medicaid | CA |
Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.