DR. WILLIAM S. CLARK (NPI# 1770690430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770690430 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM S. CLARK |
| Credential | DO |
| Practice Address |
1631 4th St Escalon CA 95320-2007 |
| Mailing Address |
1235 Mchenry Ave Modesto CA 95350-5370 |
| Practice Telephone | 2098383434 |
| Mailing Telephone | (818) 398-8527 |
| Mailing Fax Number | 2092547900 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
20A8748 | CA | Behavioral Health & Social Service Providers |
| N | 207P00000X | Emergency Medicine | 20A8748 | CA | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 20A8748 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00AX87480 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1235 Mchenry Ave, Modesto, CA 953505370 | 8183988527 | 2092547900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447819677 | William Eugene Clark | Nurse's Aide | 2869 Howey Rd, Columbus, OH 43224-4028 | 2019-06-11 |
| 1528454154 | William Clark | Specialist/Technologist | 8501 Silverbrook Rd, Lorton, VA 22079-3015 | 2015-04-10 |
| 1639575830 | William Clark | Specialist/Technologist | 7 Reef Rd, Anderson, GU 83901 | 2014-11-15 |
| 1730423278 | William Douglas Clark | Mechanotherapist | 1617 Highway 20 W, Mcdonough, GA 30253-7311 | 2012-11-21 |
| 1487950606 | William D Clark | Massage Therapist | 1160 Lucerne Loop Rd Ne, Winter Haven, FL 33881-9681 | 2011-02-04 |
| 1124320692 | William Warren Clark | Recreation Therapist | 2118 Stagecoach Trl, Temple, TX 76502-3224 | 2010-12-03 |
| 1407093875 | William Todd Clark | Specialist/Technologist, Other | 305 Greenbriar Ct, Otisco, IN 47163-9601 | 2009-01-07 |
| 1922244524 | William J Clark | Technician/Technologist | 3984 Drexel Rd, Pittsburgh, PA 15212-1512 | 2009-01-02 |
| 1023274503 | William Dave Clark | Counselor | 1421 Ossahatchie Creek Rd, Ellerslie, GA 31807-5339 | 2008-08-04 |
| 1598938219 | William Little Clark | Orthopaedic Surgery | 5 Retreat Rd, Augusta, GA 30909-1837 | 2008-04-03 |
| Street Address |
1631 4TH ST |
| City | ESCALON |
| State | CA |
| Zip Code | 95320-2007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700261963 | Guadalupe Pimentel | Chiropractor | 1631 4th St, Escalon, CA 95320-2007 | 2015-07-29 |
| 1821417866 | Escalon Physical Medicine, Inc | General Practice | 1631 4th St, Escalon, CA 95320-2007 | 2014-04-07 |
| 1891850525 | John Matthew Bystrom | Chiropractor | 1631 4th St, Escalon, CA 95320-2007 | 2006-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659742369 | Markee Cuevas | Health Educator | 19951 East Highway 120, Escalon, CA 95320 | 2015-10-08 |
| 1144699208 | Cathryn Rae Duncan | Pharmacist | 1900 Mchenry Ave., #202, Escalon, CA 95320 | 2015-09-18 |
| 1699166181 | Jessica Lee | Student in an Organized Health Care Education/Training Program | 1438 Ribier Dr., Escalon, CA 95320 | 2015-02-05 |
| 1023381647 | Kandie Rago | Pharmacist | 537 Chenin Blanc Ave, Escalon, CA 95320 | 2012-02-13 |
| 1699973768 | Rachelle Vander Dussen | Registered Nurse | 19467 Sexton Rd, Escalon, CA 95320 | 2007-07-10 |
| 1831252618 | Gary Michael Verigin | Dentist | 1415 Oklahoma Ave, Escalon, CA 95320 | 2006-12-19 |
| 1467550434 | John Phillip Tacheff | Dentist | 1302 Mitchell Ave, Escalon, CA 95320 | 2006-09-21 |
| 1013011055 | Soma Krishnamoorthi | Internal Medicine | 850 W California Street, Escalon, CA 95320-1506 | 2006-09-11 |
| 1285785154 | Krishnamoorthi M. D. Inc., A Professional Medical Corporation | Clinic/Center | 850 California St, Escalon, CA 95320-1506 | 2007-01-16 |
| 1235262817 | Michelle Coble | Social Worker | 1812 Sanchez Way, Escalon, CA 95320-1535 | 2007-03-13 |
| Find all providers in zip 95320 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821417866 | Escalon Physical Medicine, Inc | General Practice | 1631 4th St, Escalon, CA 95320-2007 | 2014-04-07 |
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| 1316553530 | Kimberly Ann Callaway | General Practice | 4893 Drakewood Ter, San Diego, CA 92130-1406 | 2020-09-22 |
| 1376156109 | Gtl Medical Group Inc | General Practice | 14555 Hamlin St Ste 107, Van Nuys, CA 91411-1617 | 2020-08-31 |
| 1922611896 | Daniel Lynn Johnson | General Practice | 74075 El Paseo Ste B2, Palm Desert, CA 92260-4118 | 2020-08-28 |
| 1235755299 | Hofmeister Medical, PC | General Practice | 31735 Riverside Dr Ste K, Lake Elsinore, CA 92530-7816 | 2020-06-24 |
| 1033733779 | South Bay Regenerative Medical Spa Inc | General Practice | 412 S Pacific Coast Hwy Ste 100, Redondo Beach, CA 90277-3712 | 2020-05-28 |
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| Find all providers with the same taxonomy | ||||
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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.