Lori J Clark, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP8950T Issued in CA

Practice address

1145 Manhattan Ave
Manhattan Beach, CA 90266-5333

Phone

(310) 546-4618

Fax

(310) 546-9268

NPI assigned

Apr 4, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lori J Clark, O.D. Inc, an Optometric Corporation

  • Corneal and Contact Management Optometrist
  • Manhattan Beach, CA
  • NPI 1952869257
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1073575213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 MANHATTAN AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665333",
            "telephone_number": "310-546-4618",
            "fax_number": "310-546-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 MANHATTAN AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665333",
            "telephone_number": "310-546-4618",
            "fax_number": "310-546-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LORI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OP8950T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0089501",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Joonhyuk Choi, PMHNP-BC, FNP-C
• Christopher Walker MD, Inc
• Christy Evans MD PC
• City of Manhattan Beach
• Andrew Clark, DPT
• Clear Recovery Center, LLC (Clear Behavioral Health)
• Ann Margaret Clevinger, DC
• Coast Pain Management, PC
• William John Cogan, D.C.
• Kenneth V Cohen, LMFT

• Optometrist in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.