West Coast Primary Care Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WEST COAST PRIMARY CARE MEDICAL GROUP

Practice address

12665 Garden Grove Blvd
Suite 301
Garden Grove, CA 92843-1901

Phone

(714) 530-7373

Fax

(714) 530-7940

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Douglas G ClarkNPI 1780688572

Title

Owner/President

Phone

(714) 530-7373

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Douglas George Clark, M.D.

  • Internal Medicine Physician
  • Garden Grove, CA
  • NPI 1780688572
  NPD (past) Authorized official

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1356536452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "SUITE 301",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431901",
            "telephone_number": "714-530-7373",
            "fax_number": "714-530-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "SUITE 301",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431901",
            "telephone_number": "714-530-7373",
            "fax_number": "714-530-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST PRIMARY CARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "714-530-7373",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• West Group Pharmaceutical Corp
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• Internal Medicine Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.