Samuel J Clark (NPI# 1689611709, PAC ID# 5991777054) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PULMONARY DISEASE.
| Nation Provider ID (NPI) | 1689611709 |
| PAC ID by PECOS | 5991777054 |
| Professional Enrollment ID | I20060420000454 |
| Full Name | Samuel J Clark |
| Organization Legal Name | SAMUEL J CLARK MD INC |
| Address |
1940 El Cajon Blvd San Diego CA 92104-1005 |
| Phone Number | 6195434500 |
| Gender | M |
| Credential | MD |
| Medical School | VANDERBILT UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1992 |
| Primary Specialty | PULMONARY DISEASE |
| Secondary Specialties | CRITICAL CARE (INTENSIVISTS), INTERNAL MEDICINE |
| Group Practice PAC ID | 0547279499 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050100 | SHARP MEMORIAL HOSPITAL |
| 050222 | SHARP CHULA VISTA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 751 Medical Ctr Ct, Chula Vista, CA 91911-6617 | 6195025800 | EMERGENCY AND ACUTE CARE MEDICAL CORPORATION |
| 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 6195434500 | SAMUEL J CLARK MD INC |
| 7901 Frost St, San Diego, CA 92123-2701 | 8589393400 | CHEST MEDICINE AND CRITICAL CARE MEDICAL GROUP INC |
| 7901 Frost St, San Diego, CA 92123-2701 | EMERGENCY AND ACUTE CARE MEDICAL CORPORATION |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_047_overall | Care Plan | 100% |
| Organization Legal Name | SAMUEL J CLARK MD INC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David C Willms | Pulmonary Disease | Samuel J Clark Md Inc | 1940 El Cajon Blvd, San Diego, CA 92104-1005 |
| Davies Y Wong | Pulmonary Disease | Samuel J Clark Md Inc | 1940 El Cajon Blvd, San Diego, CA 92104-1005 |
| Street Address |
1940 EL CAJON BLVD |
| City | SAN DIEGO |
| State | CA |
| Zip | 92104-1005 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Catherine Maywood | Infectious Disease | 1940 El Cajon Blvd, Kindred Hosp San Diego, San Diego, CA 92104-1005 | |
| David C Willms | Pulmonary Disease | Samuel J Clark Md Inc | 1940 El Cajon Blvd, San Diego, CA 92104-1005 |
| Davies Y Wong | Pulmonary Disease | Samuel J Clark Md Inc | 1940 El Cajon Blvd, San Diego, CA 92104-1005 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Beth A Domingue | Clinical Social Worker | Exodus Recovery Inc | 2950 El Cajon Blvd, Suite 4, San Diego, CA 92104-1205 |
| Jazmin Jackson | Clinical Social Worker | Exodus Recovery Inc | 4308 30th St, San Diego, CA 92104-1314 |
| Miguel Losada | General Practice | 3250 El Cajon Blvd, San Diego, CA 92104-1409 | |
| Grant S Foster | Chiropractic | 4380 Felton St, San Diego, CA 92104-1421 | |
| Matthew P Goenne | Chiropractic | 4380 Felton St, San Diego, CA 92104-1421 | |
| Amanda J Foster | Chiropractic | 4380 Felton St, San Diego, CA 92104-1421 | |
| Harvey Charles Davis | Podiatry | 4115 Ohio St, San Diego, CA 92104-1911 | |
| Patricia L Forg | Podiatry | 3989 32nd St, San Diego, CA 92104-2001 | |
| Ellen Colangelo | Clinical Psychologist | 3180 University Ave, San Diego, CA 92104-2046 | |
| Noel Marin | Psychologist, Clinical | 4048 Alabama St, Suite 1, San Diego, CA 92104-2498 | |
| Find all physicians in zip 92104 | |||
| City | SAN DIEGO |
| Zip Code | 92104 |
| Specialty | PULMONARY DISEASE |
| City + Specialty | SAN DIEGO + PULMONARY DISEASE |
Please comment or provide details below to improve the information on Samuel J Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.