Robert Edward Clark, M.D.
Individual provider Active NPI Diagnostic Radiology Physician · Selma, CA
NPI 1265480602 · NPPES record last updated Jun 10, 2011
Key facts
- NPI
- 1265480602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- C29418 (CA)
- Practice address
- 1141 Rose Ave
Selma, CA 93662-3241 - Phone
- (559) 891-6337
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- University of Minnesota Medical School, 1966
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Beverly Radiology Medical Group III
Desert Advanced Imaging Medical Center
Practice addresses (Care Compare)
222 W Eulalia St
Glendale, CA 91204-2849
Phone (818) 502-2323
35800 Bob Hope Dr
Suite 150a
Rancho Mirage, CA 92270-1740
Phone (760) 770-1920
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.25 of 100
- Quality
- 75
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.25 of 100
- Quality
- 75
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040517001386 | CA | Practitioner - Diagnostic Radiology | 4880684117 |
Reassigns benefits to 6 organizations Practice locations: El Centro, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C29418 | CA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desert Advanced Imaging Medical Center | Diagnostic Radiology | Current |
Accepting new patients |
| Cedars-Sinai Medical Care Foundation | Current |
Accepting new patients | |
| Fresno Imaging Center | Diagnostic Radiology | Current |
Accepting new patients |
| Beverly Radiology Medical Group III | Diagnostic Radiology | Current |
Accepting new patients |
| Cedars-Sinai Medical Care Foundation | Specialist | Current |
Accepting new patients |
| Beverly Radiology Medical Group III | Diagnostic Radiology | Current |
Accepting new patients |
| Beverly Radiology Medical Group III | Diagnostic Radiology | Current |
Accepting new patients |
| Open System MRI LLC. | Diagnostic Radiology | Current |
Accepting new patients |
| F&S Radiology, P.C. | Diagnostic Radiology | Past | Accepting new patients |
Locations (25 of 28)
18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444
8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100
2601 W Alameda Ave
Ste 101
Burbank, CA 91505
Phone (818) 843-7462
801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099
801 S Main St
Ste 205
Corona, CA 92882
Phone (951) 351-1025
16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020
6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433
6191 N Thesta St
Fresno, CA 93710
Phone (559) 435-7200
9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314
222 W Eulalia St
Glendale, CA 91204
Phone (818) 240-0601
250 S 12th Ave
Hanford, CA 93230
Phone (559) 295-2450
2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333
11360 Mountain View Ave
Ste C
Loma Linda, CA 92354
Phone (909) 478-3300
3320 N Los Coyotes Diagonal
Ste 120
Long Beach, CA 90808
Phone (562) 627-0903
3320 N Los Coyotes Diagonal
Ste 112
Long Beach, CA 90808
Phone (562) 627-0903
3715 E South St
Long Beach, CA 90805
Phone (562) 602-0700
8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674
27168 Newport Rd
Ste B
Menifee, CA 92584
Phone (951) 566-5725
25395 Hancock Ave
Ste 110
Murrieta, CA 92562
Phone (951) 696-4230
3909 Waring Rd
Ste Bc
Oceanside, CA 92056
Phone (760) 630-0014
72855 Fred Waring Dr
Palm Desert, CA 92260
Phone (760) 837-1420
2601 E Tahquitz Canyon Way
Palm Springs, CA 92262
Phone (760) 318-2980
35800 Bob Hope Dr
Ste 150A
Rancho Mirage, CA 92270
Phone (760) 770-1920
8283 Grove Ave
Ste 101
Rch Cucamonga, CA 91730
Phone (909) 982-8638
2428 Santa Monica Blvd
Ste 100
Santa Monica, CA 90404
Phone (310) 264-1777
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | C29418 | CA | |
| Diagnostic Radiology Physician | 2085R0202X | C29418 | CA | Yes |
Addresses
Primary practice location
1141 Rose Ave
Selma, CA 93662-3241
Mailing address
PO Box 780
Hanford, CA 93232-0780
Phone (415) 272-3517
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C294180 | Medicaid | CA | |
| 300062393 | Other | RAILROAD MEDICARE PIN |
Other providers in Selma, CA
- Julia Y Chung
- Tommy Chung
- Chung'S Pharmacy Inc
- Brenda Church
- City of Selma
- Comprehensive Addiction Program
- Luz Corona Gomez
- Country Care Assisted Living Home for the Elderly
- Courtney J Moore, Physical Therapy, Inc.
- Crestwood Behavioral Health, Inc.
All providers in Selma, CA · Diagnostic Radiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.