Robert a Clark MD Medical Corporation

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

ROBERT A CLARK MD MEDICAL CORPORATION

Doing business as

South Bay Family Eye

Practice address

4401 Atlantic Ave Ste 410
Long Beach, CA 90807-2263

Phone

(562) 459-3363

Fax

(562) 459-3364

NPI assigned

Dec 10, 2021

Last updated

Jul 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Alexander Clark, MDNPI 1043232325

Title

President

Phone

(562) 426-3925

Specialties & licenses 1

Addresses

Other names 1

• South Bay Family Eye Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Alexander Clark, M.D

  • Ophthalmology Physician
  • Long Beach, CA
  • NPI 1043232325
  Medicare reassignment Care Compare group NPD Authorized official
• Sheena Khanna, MD

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1295127835
  Medicare reassignment Care Compare group NPD
• Madeleine Francesca Puig, MD

  • Ophthalmology Physician
  • Long Beach, CA
  • NPI 1912560251
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1295494961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 DEEP VALLEY DR #2950",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902743058",
            "telephone_number": "310-707-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 ATLANTIC AVE STE 410",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072263",
            "telephone_number": "562-459-3363",
            "fax_number": "562-459-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A CLARK MD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-10",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-426-3925",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Bay Family Eye",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rex Robbins
• Scarlett Leigh Robbins, PH.D., MPH, CCC-SLP
• Don Rafael Robeniol, MSN, RN, PMHNP-BC
• Katarina Robeniol, PMHNP
• Kay Roberson, MS, MFTI
• Robert Dutile
• Robert G. Campbell, D.D.S.
• Robert L Shuman MD Inc
• Robert Lee Wilson, M.D., Medical Corporation
• Robert M Miller MD Inc

• Ophthalmology Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.