Nathan Clark, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

34906 Issued in CA

Practice address

2310 Artesia Blvd
Redondo Beach, CA 90278-3114

Phone

(310) 372-2063

NPI assigned

Sep 22, 2020

Last updated

Jan 26, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1629684873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783114",
            "telephone_number": "310-372-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783114",
            "telephone_number": "310-372-2063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2428 Santa Monica Blvd suite 308",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904049040",
            "country_code": "US",
            "telephone_number": "310-453-8393",
            "fax_number": "310-453-8696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3030 Sawtelle Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900661408",
            "country_code": "US",
            "telephone_number": "310-390-9018",
            "fax_number": "310-390-0868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NATHAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-22",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Alan Citron, PH.D.
• City of Redondo Beach
• Ann M Clark, O.D.
• Catalina Francesca Betty Clark, LM, CPM
• Heather Marie Dubbert Clark, MA, LMFT
• Tyler Keith Clark, D.C.
• Anne Louise Clary, MFT
• Clear Recovery Center, LLC (Clear Inc. Residential)
• Clear Recovery Center, LLC (Clear Behavioral Health)
• Clear Recovery Center, LLC (Clear Behavioral Health)

• Chiropractor in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.