DR. MARY ELIZABETH REVILLA CLARK (NPI# 1225109770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225109770 |
| Entity Type | Individual |
| Full Name | DR. MARY ELIZABETH REVILLA CLARK |
| Credential | M.D. |
| Practice Address |
2333 Buchanan St Suite 5823 San Francisco CA 94115-1925 |
| Practice Telephone | 4156445752 |
| Mailing Telephone | 4156445752 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2010-03-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
A98304 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA STATE LICENSE | A98304 | 01 |
| HI | HAWAII MEDICAL LICENSE | MD-12890 | 01 |
| Street Address |
2333 BUCHANAN ST SUITE 5823 |
| City | SAN FRANCISCO |
| State | CA |
| Zip Code | 94115-1925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902897515 | Barry Maurice Chauser | Radiology | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2005-11-02 |
| 1215586284 | Elizabeth Anne Carte | Genetic Counselor, MS | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2019-09-11 |
| 1063998078 | Evan C Norris | Student in an Organized Health Care Education/Training Program | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2018-07-12 |
| 1740774850 | Anastasia Vourakis | Physical Therapist | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2018-06-21 |
| 1942798541 | John Reza Yadollahi | Speech-Language Pathologist | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2018-04-29 |
| 1538666128 | Jonathan Chan | Physical Medicine & Rehabilitation | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2018-04-10 |
| 1205332756 | Vanessa Jeong | Occupational Therapist | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2018-04-03 |
| 1629584099 | Brooke Carpenter | Nurse Practitioner | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2017-12-21 |
| 1417461062 | T'racea Terrell | General Practice | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2017-11-17 |
| 1053847913 | Julia Lewis-hatheway | Student in an Organized Health Care Education/Training Program | 2333 Buchanan St, San Francisco, CA 94115-1925 | 2017-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619593274 | Francene G Colvin | Psychologist | 1939 Divisadero, Suite 1, San Francisco, CA 94115 | 2020-06-19 |
| 1760015689 | Simon James Little | Psychiatry & Neurology | 1634 Divisadero St, Suite 250, San Francisco, CA 94115 | 2020-02-19 |
| 1881243822 | Clara Kwun | Social Worker | 1610 Scott St., San Francisco, CA 94115 | 2019-09-11 |
| 1467005207 | Tamara Aline Hostetler | Marriage & Family Therapist | 2859 Sacramento St., San Francisco, CA 94115 | 2019-07-22 |
| 1962054999 | Wendy Lynne Stern | Psychologist | 2104 Bush St., San Francisco, CA 94115 | 2019-07-10 |
| 1184188476 | Katherine Marie Carroll | Specialist/Technologist | 1731 B Buchanan Street, San Francisco, CA 94115 | 2019-01-30 |
| 1710467410 | Joanna Katherine Hendrick | Marriage & Family Therapist | 1201 Fillmore Street, San Francisco, CA 94115 | 2018-08-21 |
| 1063998771 | Leonard Cheung | Counselor | Youth Services Bureau of San Francisco, 1426 Fillmore Street Suite 216, San Francisco, CA 94115 | 2018-07-16 |
| 1942709563 | Jobelle Cunanan | Behavior Technician | 1871 Turk St, San Francisco, CA 94115 | 2018-02-09 |
| 1083128235 | Dr. Jenny Mann, Nd | Clinic/Center | 2300 Sutter St Ste 301, San Francisco, CA 94115 | 2017-11-27 |
| Find all providers in zip 94115 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366958662 | Insite Digestive Health Care | Internal Medicine | 2186 Geary Blvd Ste 320, San Francisco, CA 94115-3457 | 2017-12-21 |
| 1194134460 | Jeanne-marie Giard | Internal Medicine | 513 Parnassus Ave Rm S-357, San Francisco, CA 94143-2205 | 2014-08-11 |
| 1396019691 | Mission Gastroenterology and Hepatology Inc | Internal Medicine | 1580 Valencia St Ste 106, San Francisco, CA 94110-4420 | 2012-03-04 |
| 1760751176 | Thomas P Twaddell | Internal Medicine | 600 Duncan St, San Francisco, CA 94131-1841 | 2011-12-14 |
| 1558500603 | Joseph Chen | Internal Medicine | Department of Gastroenterology 513 Parnassus Ave, Room S-357, Box 0538, San Francisco, CA 94143-0001 | 2009-02-12 |
| 1326228487 | Yen N Quang | Internal Medicine | 1199 Bush St Ste 560, San Francisco, CA 94109 | 2007-11-06 |
| 1639212624 | Robert J Elsen | Internal Medicine | 45 Castro St Ste 437, San Francisco, CA 94114-1029 | 2007-02-15 |
| 1720130263 | Ies Medical Group, Inc. | Internal Medicine | 1101 Van Ness Ave Rm 31583d, San Francisco, CA 94109-6919 | 2007-01-17 |
| 1003964826 | Wing K Kam | Internal Medicine | 3838 California St Rm 108, San Francisco, CA 94118-1504 | 2007-01-08 |
| 1417017435 | San Francisco Digestive Disease Medical Group Inc A Prof Corp | Internal Medicine | 1 Shrader St Ste 500, San Francisco, CA 94117-1044 | 2006-12-11 |
| Find all providers in SAN FRANCISCO | ||||
| City | SAN FRANCISCO |
| Zip Code | 94115 |
Please comment or provide details below to improve the information on DR. MARY ELIZABETH REVILLA CLARK.
| 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.