Provider Demographics
NPI:1215291612
Name:OLCOTT, CLARA MAN-CHING (MD)
Entity type:Individual
Prefix:DR
First Name:CLARA
Middle Name:MAN-CHING
Last Name:OLCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1030 E FOOTHILL BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4069
Mailing Address - Country:US
Mailing Address - Phone:909-981-5859
Mailing Address - Fax:909-981-8293
Practice Address - Street 1:1030 E FOOTHILL BLVD STE 101
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786
Practice Address - Country:US
Practice Address - Phone:909-981-5859
Practice Address - Fax:909-981-8293
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA156211207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology