John J Clark, OD, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JOHN J CLARK, OD, INC.

Practice address

75 N Broadway
Chula Vista, CA 91910-1417

Phone

(619) 427-5367

NPI assigned

Jan 25, 2024

Organization subpart

No

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

Authorized official

Name

Dr. John J Clark, ODNPI 1285782375

Title

President

Phone

(619) 884-5225

Specialties & licenses 1

Addresses

Practitioners 1

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

• John J Clark Jr., OD

  • Corneal and Contact Management Optometrist
  • Chula Vista, CA
  • NPI 1285782375
  NPD Authorized official

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

{
    "created_epoch": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1245092154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2952 W CANYON AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234652",
            "telephone_number": "619-884-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N BROADWAY",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919101417",
            "telephone_number": "619-427-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J CLARK, OD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-884-5225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Chula Vista, CA
• Optometrist in California

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

Verify at the official NPI Registry.