Doctor Name: | ERICA FAN CLAYTON |
NPI Number: | 1194959940 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | MT195065 |
Business Practice Address: | 250 Bon Air Rd Greenbrae, CA - 949041702 |
Business Phone Number: | 4159257174 |
Business Fax Number: | 4158980870 |
Mailing Address: | 1615 Hill Rd Ste B, NOVATO |
State: | CA |
Postal Code: | 949474338 |
Phone Number: | 4158987649 |
Fax Number: | 4158980870 |
NPI Enumeration Date: | 05/08/2009 |
NPI Last Update Date: | 06/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | MT195065 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |