| Doctor Name: | DR. DEBRA S CLYDE |
| NPI Number: | 1528173986 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | G86850 |
| Business Practice Address: | 741 North Main Street Cedarville, CA - 96104 |
| Business Phone Number: | 5302796111 |
| Business Fax Number: | 5302792680 |
| Mailing Address: | 741 North Main Street, P.o. Box 246 CEDARVILLE |
| State: | CA |
| Postal Code: | 96104 |
| Phone Number: | 5302796111 |
| Fax Number: | 5302792680 |
| NPI Enumeration Date: | 08/19/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | G86850 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |