Samuel J. Clark, M.D., Inc.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

SAMUEL J. CLARK, M.D., INC.

Practice address

1940 El Cajon Blvd
San Diego, CA 92104-1005

Phone

(619) 218-5688

Fax

(619) 795-3991

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Samuel J. Clark, M.D.NPI 1689611709

Title

President

Phone

(619) 218-5688

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel J. Clark, M.D.

  • Pulmonary Disease Physician
  • San Diego, CA
  • NPI 1689611709
  Medicare reassignment Care Compare group NPD Authorized official
• Soud Sediqe I, M.D.

  • Pulmonary Disease Physician
  • San Diego, CA
  • NPI 1366820540
  Medicare reassignment Care Compare group NPD
• David C Willms, M.D.

  • Pulmonary Disease Physician
  • San Diego, CA
  • NPI 1285626747
  Medicare reassignment Care Compare group NPD
• Davies Wong, M.D.

  • Pulmonary Disease Physician
  • San Diego, CA
  • NPI 1841282407
  Medicare reassignment NPD

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1124079793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 881609",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921681609",
            "telephone_number": "619-794-2521",
            "fax_number": "619-794-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041005",
            "telephone_number": "619-218-5688",
            "fax_number": "619-795-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL J. CLARK, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-218-5688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyra Marina Samson, MD
• Rachel Tagum Samson, MSN, FNP-C
• Uyen Samson, PHARM.D
• Samuel Donohoe, MD, Inc.
• Samuel G Soliven DDS Inc
• Samuel Kressin Acupuncture Apc
• Samantha Samuel-Williams, PA
• Julia Evelyn Samuel
• Nebiyou Samuel
• Donald Samuels Sr., P.P.S.

• Pulmonary Disease Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.