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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Clara Lucy Polak | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Clara | [sources] | |||
| Last name | Polak | [sources] | |||
| Middle name | Lucy | [sources] | |||
| NPI | 1790749208 · 1841342243 | [sources] | |||
| Registration number | 00A666490 · A 66649 · GR0105180 | [sources] | |||
| Sector | Physician | [sources] | |||
| Address | 8587 Harwell Drive, San Diego, CA, 92119 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States · DHCS
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