Organization Name: | CLEAR PATH CENTER |
NPI Number: | 1215386776 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AWAIS SIDDIKI (OWNER) |
Mailing Address: | 2364 Main St Suite A Philomath |
State: | OR US |
Postal Code: | 973709488 |
Phone Number: | 5413244594 |
Fax Number: | 5417080949 |
NPI Enumeration Date: | 06/06/2016 |
NPI Last Update Date: | 06/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0401X |
License Number: | MD176723 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A family medicine physician who specializes in the diagnosis and treatment of addictions. |