Provider Demographics
NPI:1518952860
Name:CLARK-SAYLES, CATHARINE TERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHARINE
Middle Name:TERESA
Last Name:CLARK-SAYLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 S ELISEO DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2000
Mailing Address - Country:US
Mailing Address - Phone:415-464-8176
Mailing Address - Fax:415-464-8177
Practice Address - Street 1:1341 S ELISEO DR
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2000
Practice Address - Country:US
Practice Address - Phone:415-464-8176
Practice Address - Fax:415-464-8177
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49182207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G491820Medicaid
CA00G491820Medicaid
CA00G491820Medicare ID - Type Unspecified