DR. GARY C. CLARK (NPI# 1518042274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518042274 |
| Entity Type | Individual |
| Full Name | DR. GARY C. CLARK |
| Credential | M.D. |
| Practice Address |
7901 Frost St Sharp Memorial Hospital San Diego CA 92123-2701 |
| Mailing Address |
2956 Mcgraw St San Diego CA 92117-6045 |
| Practice Telephone | 8589393525 |
| Mailing Telephone | 5106102721 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-10-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | G50138 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G501380 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548876048 | Gary Lee Clark | In Home Supportive Care | 71312 Woods Ave, Martins Ferry, OH 43935-3104 | 2020-09-20 |
| 1588085302 | Gary Marvin Clark | Pharmacist | 15227 Aurora Cir, Urbandale, IA 50323-2472 | 2013-12-20 |
| 1487855961 | Gary K. Clark | Dentist | 9730 S 700 E Ste 106, Sandy, UT 84070-4503 | 2007-05-30 |
| 1174649172 | Gary Clark | Social Worker | 502 W 143rd St, Suite 3a, New York, NY 10031-6507 | 2007-03-21 |
| 1912022484 | Gary Mike Clark | Marriage & Family Therapist | 8911 3rd Street Rd, Louisville, KY 40272-2501 | 2007-03-20 |
| 1013987759 | Gary Wayne Clark | Family Medicine | 125 Canton Rd Nw, Carrollton, OH 44615-1009 | 2006-01-25 |
| 1609861152 | Gary W Clark | Podiatrist | 166 W 1325 N, Suite 300, Cedar City, UT 84721-7792 | 2005-09-12 |
| 1972140713 | Gary Clark | Behavior Technician | 100 Spenryn Dr, Madison, AL 35758-1890 | 2019-11-27 |
| 1043514540 | Gary D Clark | Pharmacist | 2701 S Nc 127 Hwy, Hickory, NC 28602-9130 | 2010-12-27 |
| 1902962939 | Gary Bruce Clark | General Practice | 1790 30th St, Suite 230, Boulder, CO 80301-1022 | 2006-12-27 |
| Street Address |
7901 FROST ST SHARP MEMORIAL HOSPITAL |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-2701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730176785 | Kristine Lynn Ortiz | Nurse Practitioner | 7901 Frost St, Sharp Memorial Hospital Cardiac Transplant Department, San Diego, CA 92123-2701 | 2005-10-04 |
| 1780285650 | Michelle Aubrey Hawkes | Nurse Practitioner | 7901 Frost St, San Diego, CA 92123-2701 | 2020-11-05 |
| 1144830548 | Erin Stiefel | Nurse Practitioner | 7901 Frost St, San Diego, CA 92123-2701 | 2020-07-31 |
| 1043832314 | Sharan Dhoot | Pharmacist | 7901 Frost St, San Diego, CA 92123-2701 | 2020-05-10 |
| 1295375079 | Natsurang Chong Corporation | Internal Medicine | 7901 Frost St, San Diego, CA 92123-2701 | 2020-01-09 |
| 1073161329 | Andrea Boettcher | Internal Medicine | 7901 Frost St, San Diego, CA 92123-2701 | 2019-08-29 |
| 1790337368 | Sarah Norwid | Nurse Practitioner | 7901 Frost St, San Diego, CA 92123-2701 | 2019-07-12 |
| 1235629296 | Celeste Briones | Pharmacist | 7901 Frost St, San Diego, CA 92123-2701 | 2018-05-15 |
| 1952818601 | Jessica J Reyes | Nurse Practitioner | 7901 Frost St, San Diego, CA 92123 | 2018-01-03 |
| 1255846341 | Bradley Iannucci | Licensed Vocational Nurse | 7901 Frost St, San Diego, CA 92123-2701 | 2017-12-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295361772 | William Robert Berry | Surgery | 5775 Del Cerro Blvd, San Diego, CA 92120-4513 | 2020-03-17 |
| 1376185116 | Charles Theuer | Surgery | 4350 La Jolla Village Dr Ste 800, San Diego, CA 92122-1247 | 2019-10-14 |
| 1538656202 | Stewart Reese Logan | Surgery | 200 W Arbor Dr # Mc7220, San Diego, CA 92103-1911 | 2018-04-18 |
| 1447773114 | R R Gohil Md Apc | Surgery | 6386 Alvarado Ct Ste 330, San Diego, CA 92120-4908 | 2017-07-25 |
| 1720475148 | Advanced Wound Care, Inc | Surgery | 5124 Bloch St, San Diego, CA 92122-4005 | 2015-04-23 |
| 1841532843 | San Diego Emergency Physician Services, Inc. | Surgery | 6487 Dwane Ave, San Diego, CA 92120-3924 | 2013-03-18 |
| 1336488485 | Victor Herbert Lidner | Surgery | 809 Deal Ct, San Diego, CA 92109-8131 | 2013-02-10 |
| 1588909097 | San Diego Advanced Surgery P.C. | Surgery | 3245 University Ave # 501, San Diego, CA 92104-2009 | 2012-12-10 |
| 1700121472 | Vadim Avulov | Surgery | 6699 Alvarado Rd Ste 2309, San Diego, CA 92120-5241 | 2012-12-06 |
| 1194075861 | Rachel Kaye Voss | Surgery | 3146 Cowley Way, Apt 4, San Diego, CA 92117-6519 | 2012-09-10 |
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| 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.