DR. PETER CLARK (NPI# 1528113628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528113628 |
| Entity Type | Individual |
| Full Name | DR. PETER CLARK |
| Credential | M.D. |
| Practice Address |
85 Sierra Park Rd Mammoth Lakes CA 93546-0660 |
| Mailing Address |
Po Box 660 85 Sierra Park Rd Mammoth Lakes CA 93546-0660 |
| Practice Telephone | 7609342551 |
| Practice Fax Number | 7609244081 |
| Mailing Telephone | 7609234255 |
| Mailing Fax Number | 7609244081 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2013-03-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A68635 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548616485 | Peter Clark | Ophthalmology | 3601 4th St Rm 2a100, Lubbock, TX 79430-1931 | 2016-05-10 |
| 1154660314 | Peter Edward Clark | Physical Therapy Assistant | 630 Linda Ct, Palm Harbor, FL 34684-4624 | 2013-02-07 |
| 1407174998 | Peter A Clark | Social Worker | 10 Water St Ste 306, Waterville, ME 04901-6566 | 2010-05-10 |
| 1447310289 | Peter Clark | Psychologist | 203 W 21st Ave, Covington, LA 70433-3151 | 2006-12-11 |
| 1821106709 | Peter Clark | Internal Medicine | 670 Sierra Rose Dr, Reno, NV 89511-2072 | 2006-08-29 |
| 1891789087 | Peter Michael Clark | Specialist/Technologist | 23 Bridgton Rd, Westbrook, ME 04092-3653 | 2005-09-02 |
| 1679575385 | Peter Clark | Contractor | 785 Central Rd, Rye Beach, NH 03871-9005 | 2005-08-12 |
| 1346511094 | Peter James Clark | Specialist/Technologist | 502 E Boone Ave, Ad Box 66, Spokane, WA 99258-1774 | 2012-01-25 |
| 1710294434 | Peter Clark | Counselor | 519 17th St, Suite 210, Oakland, CA 94612-1527 | 2010-09-01 |
| 1164664967 | Peter J Clark | Psychiatry & Neurology | 99 Beauvoir Ave, Summit, NJ 07901-3533 | 2009-03-25 |
| Street Address |
85 SIERRA PARK RD |
| City | MAMMOTH LAKES |
| State | CA |
| Zip Code | 93546-0660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346225653 | Amy Conrad | Pediatrics | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-2073 | 2005-12-08 |
| 1861969370 | Elaine Alrutz | Physical Therapist | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-2073 | 2018-11-01 |
| 1548770837 | Cara Dolan Crosby | Physician Assistant | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-2073 | 2017-10-02 |
| 1225490659 | Sarah Ruberman | Pediatrics | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-2073 | 2016-03-24 |
| 1124402417 | Casey Piercey | Dietitian, Registered | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-2073 | 2015-07-16 |
| 1619372281 | Rita Klabacha | Physician Assistant | 85 Sierra Park Rd, Family Medicine Clinic, Mammoth Lakes, CA 93546-2073 | 2014-10-24 |
| 1386046662 | Evan Rowley | Physician Assistant | 85 Sierra Park Rd, Mammoth Hospital, Mammoth Lakes, CA 93546-2073 | 2014-09-18 |
| 1952716722 | Kimdoc LLC | Family Medicine | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-2073 | 2014-06-30 |
| 1417373770 | Carolyn Korfiatis | Registered Nurse | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-2073 | 2014-03-11 |
| 1861821977 | Araya Medicine Inc | Internal Medicine | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-2073 | 2013-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513433 | Luisana Beatriz Baires | Case Manager/Care Coordinator | 1290 Tavern Rd., Mammoth Lakes, CA 93546 | 2020-09-21 |
| 1679106371 | Jesica Jasmin Ramos Castelan | Case Manager/Care Coordinator | 365 Sierra Park Rd, Mammoth Lakes, CA 93546 | 2020-02-20 |
| 1669970224 | Andres Villalpando | Case Manager/Care Coordinator | 452 Old Mammoth Rd Suit 304, Mammoth Lakes, CA 93546 | 2018-01-30 |
| 1598278467 | Eastern Sierra Counseling and Consulting | Social Worker | 272 Sierra Manor, Suite B1, Mammoth Lakes, CA 93546 | 2017-11-14 |
| 1053771949 | Sofia Carolina Flores | Counselor | 451 Old Mammoth Rd, 304, Mammoth Lakes, CA 93546 | 2016-03-04 |
| 1669848180 | Jennifer Liebersbach | Chiropractor | 645 Old Mammoth Rd., Mammoth Lakes, CA 93546 | 2015-08-19 |
| 1316281918 | France Jacqueline Fischer | Behavioral Analyst | 2251 Meridian Blvd., Mammoth Lakes, CA 93546 | 2012-11-20 |
| 1366712424 | Richard Charles Bonneau | Counselor | 452 Old Mammoth Rd, 3rd Floor, Mammoth Lakes, CA 93546 | 2012-01-06 |
| 1407155435 | Mammoth Lakes Fire Protection District | Ambulance | 3150 Main Street, Mammoth Lakes, CA 93546 | 2011-03-16 |
| 1588964381 | Nancy Ellen Johnson | Pharmacist | 481 Old Mammoth Road, Mammoth Lakes, CA 93546 | 2010-10-26 |
| Find all providers in zip 93546 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952692378 | Roger L Claypool | Family Medicine | 1934 Meridian Blvd., Mammoth Lakes, CA 93546-3098 | 2011-04-20 |
| 1952716722 | Kimdoc LLC | Family Medicine | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-2073 | 2014-06-30 |
| 1437204534 | Dennis L. Crunk | Family Medicine | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-0660 | 2007-01-25 |
| 1922153014 | Mary Bassler | Family Medicine | 85 Sierra Park Rd, Mammoth Lakes, CA 93546-0660 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407711 | Prohealth Partners A Medical Group | Family Medicine | 3700 Katella Ave Ste D, Los Alamitos, CA 90720-6410 | 2020-11-06 |
| 1831790112 | Universal Healthcare Services, Inc. | Family Medicine | 6025 Niles St, Bakersfield, CA 93306-4696 | 2020-11-04 |
| 1568063923 | Claude Kathy Marquis | Family Medicine | 400 S June St, Los Angeles, CA 90020-4812 | 2020-11-03 |
| 1417558842 | San Judas Tadeo Medical Group, Inc. | Family Medicine | 1000 S La Brea Ave Ste 2, Inglewood, CA 90301-3869 | 2020-11-03 |
| 1174123038 | Socal Medical Center., Inc. | Family Medicine | 1350 E Los Angeles Ave Ste 204, Simi Valley, CA 93065-2860 | 2020-10-29 |
| 1205435864 | Montana Affinity LLC | Family Medicine | 820 N Mountain Ave Ste 103, Upland, CA 91786-4163 | 2020-10-23 |
| 1861091126 | Silvia Diego Md Inc A Professional Medical Corp | Family Medicine | 1317 Oakdale Rd Ste 100, Modesto, CA 95355-3362 | 2020-10-19 |
| 1245838879 | Lalaine Talagtag Smith | Family Medicine | 919 Mariner Dr Apt C, Mountain View, CA 94043-3372 | 2020-10-15 |
| 1417554023 | Hameed A. Khan, M.d., Inc. | Family Medicine | 3655 Lomita Blvd Ste 421, Torrance, CA 90505-1934 | 2020-10-06 |
| 1073120085 | Garrison Family Medical Group Inc | Family Medicine | 41210 11th St W Ste C, Palmdale, CA 93551-1447 | 2020-09-24 |
| Find all providers with the same taxonomy | ||||
| City | MAMMOTH LAKES |
| Zip Code | 93546 |
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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.