SAMUEL J. CLARK, M.D., INC.


Address: 1940 El Cajon Blvd, San Diego, CA 92104-1005
Phone: 6192185688

SAMUEL J. CLARK, M.D., INC. (NPI# 1124079793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124079793
Entity Type Organization
Organization Name SAMUEL J. CLARK, M.D., INC.
Practice Address 1940 El Cajon Blvd
San Diego
CA 92104-1005
Practice Telephone 6192185688
Practice Fax Number 6197953991
Mailing Telephone 6192185688
Mailing Fax Number 6197953991
Enumeration Date 2006-05-16
Last Update Date 2020-08-22
Authorized Official Name DR. SAMUEL J. CLARK (PRESIDENT)
Authorized Official Telephone 6192185688
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
Allopathic & Osteopathic Physicians

Office Location

Street Address 1940 EL CAJON BLVD
City SAN DIEGO
State CA
Zip Code 92104-1005

Providers in the same location

NPI Name Taxonomy Address Enumeration
1073143848 Sandra M. Hayes, Medical Services, Inc. Preventive Medicine 1940 El Cajon Blvd, San Diego, CA 92104-1005 2020-01-21
1013557636 Js Cardiology Internal Medicine 1940 El Cajon Blvd, San Diego, CA 92104-1005 2020-01-11
1699317644 Avicenna Critical Care, PC Internal Medicine 1940 El Cajon Blvd, San Diego, CA 92104-1005 2019-10-10
1912471756 Shelby Turner Occupational Therapist 1940 El Cajon Blvd, San Diego, CA 92104-1005 2019-01-15
1396256558 Catherine Maywood, M.d., A Professional Corporation Internal Medicine 1940 El Cajon Blvd, San Diego, CA 92104-1005 2017-10-16
1699209577 Diana Nawrocki Physical Therapist 1940 El Cajon Blvd, San Diego, CA 92104-1005 2017-04-17
1083070189 California Emergency Physicians Medical Group, A Professional Corp Internal Medicine 1940 El Cajon Blvd, San Diego, CA 92104-1005 2016-01-06
1942600416 Catherine Aquino Registered Nurse 1940 El Cajon Blvd, San Diego, CA 92104-1005 2014-09-02
1528336211 Dr. Gerardo B. Martin, Inc. Family Medicine 1940 El Cajon Blvd, San Diego, CA 92104-1005 2011-12-08
1881923951 Knd Development 59 LLC Hospitalist 1940 El Cajon Blvd, San Diego, CA 92104-1005 2009-12-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1750933610 Hinderberger Dental Corporation Dentist 2050 El Cajon Boulevard, San Diego, CA 92104 2019-07-11
1912487265 Graham Ashton Harris Dentist 2310 Craven Street, Bldg 3230, Fpo, AA 92104 2018-08-16
1700393485 Christian Jacot Occupational Therapy Assistant 3128 Nile Street, San Diego, CA 92104 2018-01-04
1316452931 Enrico Resurreccion Santos Dental Hygienist 2310 Craven St. Bldg. 3230, San Diego, CA 92104 2017-12-05
1164940789 Robert Brian Damone Acupuncturist 3370 29th Street, San Diego, CA 92104 2017-09-04
1780100636 Nicole Palacios Counselor 4170 Texas Street, Apt 1, San Diego, CA 92104 2017-08-22
1063938587 Indie C Oliver Landrum Case Manager/Care Coordinator 2220 Broadway, San Diego, CA 92104 2017-08-16
1669829008 Krystah Lynn Smith Doula 3370 Cherokee Ave, Unit 43, San Diego, CA 92104 2016-05-16
1063871853 Holly Nicole Hinderberger Dentist 2050 El Cajon Blvd, San Diego, CA 92104 2016-02-22
1316336258 Jorge E Talavera Military Health Care Provider 3875 Florida St Apt 2, San Diego, CA 92104 2015-01-15
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Taxonomy Information

Taxonomy Code 207RP1001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Pulmonary Disease

Taxonomy Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1093198392 Abdurrahman Akhlaq Husain Internal Medicine 8555 Aero Dr Ste 104, San Diego, CA 92123-1744 2015-07-04
1639447337 Richard David Kremsdorf Internal Medicine 4172 Combe Way, San Diego, CA 92122-2511 2011-12-08
1962738641 Xavier Soler Internal Medicine 200 West Arbor Dr - 8201, Ucsd Medical Center, San Diego, CA 92103-8201 2009-10-30
1437327053 Jan Rodger Radke Internal Medicine 13241 Luckett Ct, San Diego, CA 92130-3225 2008-02-16
1134190945 Kenneth Lee Eisenberg Internal Medicine 3480 Bob Wilson Drive, Nmcsd,att Medical Staff Services, San Diego, CA 92134 2006-01-30
1023006418 Gregg Garner Internal Medicine 1684 Torrance St, San Diego, CA 92103-3746 2005-10-10
1922008598 Gang Bao Internal Medicine 6699 Alvarado Rd Ste 2306, San Diego, CA 92120-5241 2005-07-26
1891280228 Gregory P. Ranches Md, Apc Internal Medicine 501 Washington St., Ste 508, San Diego, CA 92103 2018-06-27
1891207171 Iha Pulmonary Inc Internal Medicine 7801 Mission Center Ct, San Diego, CA 92108-1313 2017-10-26
1023436417 Jisha K. Joshua Internal Medicine 200 W Arbor Dr, San Diego, CA 92103-9000 2014-04-02
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Competitor

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City SAN DIEGO
Zip Code 92104

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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