Debra Jean Clydesdale, L.A.C.

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

AC 08548 Issued in CA

Practice address

23441 Madison St
Suite 220
Torrance, CA 90505-4725

Phone

(310) 373-0191

NPI assigned

Apr 23, 2007

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942428115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 19TH ST APT B",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041238",
            "telephone_number": "310-663-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23441 MADISON ST",
            "address_2": "SUITE 220",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054725",
            "telephone_number": "310-373-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYDESDALE",
        "first_name": "DEBRA",
        "middle_name": "JEAN",
        "credential": "L.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "AC 08548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Clemmensen
• Adam Clevinger, MS, BCBA
• Karen Merrer Cline
• David Joseph Cloutier, O.D.
• CLS Medical Group Inc
• Cna Medical Group, Inc
• CNS Medical PC
• Sabrina Rae Verzosa Co
• Coast Cities Surgery Center, Inc
• Coast Dermatology Medical Associates Inc

• Preventive Medicine/Occupational Environmental Medicine Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.