Organization Active NPI

Clara Lucky Polak MD, Inc.

  • Endocrinology, Diabetes & Metabolism Physician
  • National City, CA
National Provider Identifier
1356586465
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
CLARA LUCKY POLAK MD, INC.
Practice address
22 W 35TH St Ste 101
National City, CA 91950-7926
Phone
(619) 427-3361
NPI assigned
Dec 4, 2008
Organization subpart
Yes
Parent organization
CLARA LUCKY POLAK MD, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

Name
Clara Lucy Polak, MD
Title
Medical Director
Phone
(619) 427-3362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

22 W 35TH St Ste 101
National City, CA 91950-7926

Mailing address

9276 Scranton Rd
Suite 100
San Diego, CA 92121-7701

Other names 1

  • My Chula Vista Doctors Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clara Lucy Polak MD Inc2 organizations share this tax ID, including this one
Part of
Clara Lucy Polak MD Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1356586465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 SCRANTON RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921217701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W 35TH ST STE 101",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919507926",
            "telephone_number": "619-427-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARA LUCKY POLAK MD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLARA LUCKY POLAK MD, INC.",
        "enumeration_date": "2008-12-04",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "CLARA",
        "authorized_official_middle_name": "LUCY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "619-427-3362",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Chula Vista Doctors",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.