DR. CHAD LEROY CLARK (NPI# 1023052545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023052545 |
| Entity Type | Individual |
| Full Name | DR. CHAD LEROY CLARK |
| Credential | M.D. |
| Practice Address |
3865 Jackson St Riverside CA 92503-3919 |
| Mailing Address |
Po Box 661987 Arcadia CA 91066-1987 |
| Practice Telephone | 9513525666 |
| Practice Fax Number | 9513525445 |
| Mailing Telephone | 6264470296 |
| Mailing Fax Number | 6264476057 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2008-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | A70662 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A706620 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831536994 | Chad Alan Clark | Physical Therapist | 560 Memorial Dr Ste C, Pocatello, ID 83201-4073 | 2013-05-30 |
| 1215227525 | Chad Joseph Clark | Counselor | 10201 E 5th St, Tulsa, OK 74128-2617 | 2011-04-08 |
| 1083617906 | Chad Alan Clark | Physical Therapist | 58 Glenroyal Dr, Pueblo, CO 81005-2174 | 2005-05-24 |
| 1265912836 | Chad Curtis Clark | Technician | 4326 W. Cheyenne Ave (suite 100), North Las Vegas, NV 89032 | 2018-08-14 |
| 1205241577 | Chad Clark | Optometrist | 5201 Hamilton Blvd, Allentown, PA 18106-9113 | 2014-06-25 |
| 1346339496 | Chad Jeremy Clark | Family Medicine | 900 Round Valley Dr, Suite 200, Park City, UT 84060-7552 | 2006-10-12 |
| 1881659258 | Chad David Clark | Physician Assistant | 85 Mcnaughten Rd, Ste 110, Columbus, OH 43213-2174 | 2006-04-19 |
| 1275517831 | Chad Michael Clark | Radiology | 620 Summit Crossing Pl, Ste 106, Gastonia, NC 28054-2176 | 2005-12-06 |
| Street Address |
3865 JACKSON ST |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92503-3919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225038953 | Parkview Community Hospital Medical Center | General Acute Care Hospital | 3865 Jackson St, Riverside, CA 92503-3919 | 2005-07-22 |
| 1831722826 | Samantha Rocha | Speech-Language Pathologist | 3865 Jackson St, Riverside, CA 92503-3919 | 2020-02-18 |
| 1588203814 | Nayer Benyamin | Pharmacist | 3865 Jackson St, Riverside, CA 92503-3919 | 2020-01-03 |
| 1124596382 | Doctors Hospital of Riverside LLC | General Acute Care Hospital | 3865 Jackson St, Riverside, CA 92503-3919 | 2018-11-06 |
| 1316458896 | Christine Ayad | Pharmacist | 3865 Jackson St, Riverside, CA 92503-3919 | 2017-10-23 |
| 1730530494 | Kheiter Inc | Internal Medicine | 3865 Jackson St, Riverside, CA 92503 | 2016-06-23 |
| 1508227513 | Beshoui Helkani | Pharmacist | 3865 Jackson St, Riverside, CA 92503 | 2016-03-18 |
| 1255719266 | Neel Pandya | Anesthesiology | 3865 Jackson St, Riverside, CA 92503 | 2015-05-11 |
| 1518369289 | Calvin Purushottam Patel | Family Medicine | 3865 Jackson St, Ste. 106-526, Riverside, CA 92503-3919 | 2014-09-24 |
| 1144636325 | Tanzeem Islam | Anesthesiology | 3865 Jackson St, Riverside, CA 92503 | 2014-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255953618 | Mohammad Abul-fielat Dds Inc | Dentist | 3825 Tyler St, Riverside, CA 92503 | 2020-05-08 |
| 1205396488 | Francisco Aguayo | Behavioral Analyst | 3345 Jackson St, Riverside, CA 92503 | 2019-03-22 |
| 1073071684 | Racheal Ego Aneke | Nurse Practitioner | 9890 County Farm Rd., Building 2, Riverside, CA 92503 | 2019-03-04 |
| 1073070264 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 3500 Tyler Mall, Riverside, CA 92503 | 2019-02-25 |
| 1053893271 | Tsibel Dental Practice Inc. | Dentist | 10181 Magnolia Ave, Riverside, CA 92503 | 2018-09-04 |
| 1508344714 | Patricia Marraine Redondo | Counselor | 1625 14th St, Riverside, CA 92503 | 2018-07-31 |
| 1740766146 | Robles Rodef & Yaghoubi Dental Corporation | Dentist | 5628 Van Buren Blvd Suite #a, Riverside, CA 92503 | 2018-07-18 |
| 1467961755 | Daniela Popa | Assisted Living Facility | 10820 Calle Bella, Riverside, CA 92503 | 2017-09-29 |
| 1457860306 | Leah Dreany | Peer Specialist | 2085 Rustin Avenue Building #3, Riverside, CA 92503 | 2017-09-22 |
| 1710400445 | Christopher John Guting | Peer Specialist | 10230 Indiana Avenue, Riverside, CA 92503 | 2017-07-25 |
| Find all providers in zip 92503 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780038505 | Nash David Martinez | Emergency Medicine | 10800 Magnolia Ave Dept of Emergency Medicine, Kaiser Permanente Hospital, Riverside, CA 92505 | 2016-04-18 |
| 1669848222 | Desiree Ann Pasillas | Emergency Medicine | 3257 Pontiac Ave, Riverside, CA 92509-4430 | 2015-08-18 |
| 1982997250 | Daniel Ng | Emergency Medicine | 4445 Magnolia Ave Dept Of, Riverside, CA 92501-4135 | 2011-05-19 |
| 1710202924 | Jared J Marcucci | Emergency Medicine | 399 Blythe Rd, Riverside, IL 60546-1703 | 2010-03-30 |
| 1548448970 | Roberta Jean Dunn-dixon | Emergency Medicine | 4443 Magnolia Ave, Emergency Department, Riverside, CA 92501 | 2008-02-07 |
| 1124057757 | Horace Charles Stevens | Emergency Medicine | 4581 Luther St, Riverside, CA 92504-2231 | 2006-07-03 |
| 1083612824 | Ernest Woodhouse | Emergency Medicine | 4440 Magnolia Ave., Riverside, CA 92501 | 2005-07-13 |
| 1396249793 | Ashkan Morim | Emergency Medicine | 4445 Magnolia Ave, Riverside, CA 92501 | 2018-03-20 |
| 1417488792 | Rebecca C. Bishop | Emergency Medicine | 4445 Magnolia Ave, Riverside, CA 92501-4135 | 2017-03-27 |
| 1033640073 | John Christian Canet Costumbrado | Emergency Medicine | 4445 Magnolia Ave, Riverside, CA 92501-4135 | 2017-03-22 |
| Find all providers in RIVERSIDE | ||||
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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.