Provider Demographics
NPI:1750587671
Name:POMROY, CLINTON MADISON (ND)
Entity type:Individual
Prefix:DR
First Name:CLINTON
Middle Name:MADISON
Last Name:POMROY
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5348 LEWIS RD
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-2620
Mailing Address - Country:US
Mailing Address - Phone:818-879-1123
Mailing Address - Fax:
Practice Address - Street 1:23945 CALABASAS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1552
Practice Address - Country:US
Practice Address - Phone:818-224-2404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND 44175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath