Provider Demographics
NPI:1992140131
Name:CLAYDON, ELIZABETH M (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:CLAYDON
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 1:150 CATHERINE LN STE B
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5719
Mailing Address - Country:US
Mailing Address - Phone:530-271-2100
Mailing Address - Fax:
Practice Address - Street 1:150 CATHERINE LN STE B
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5719
Practice Address - Country:US
Practice Address - Phone:530-271-2100
Practice Address - Fax:833-992-0805
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA143525207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine