Active NPI
Stanley D. Clark, PHARM.D.
- Pharmacist
- Burlingame, CA
National Provider Identifier
1376978239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH 2524
- Practice address
- 2501 Poppy Dr
Burlingame, CA 94010-5533 - Phone
- (650) 759-0719
- NPI assigned
- Sep 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH 2524 | CA | Primary |
Addresses
Primary practice location
2501 Poppy Dr
Burlingame, CA 94010-5533
Mailing address
2501 Poppy Dr
Burlingame, CA 94010-5533
Phone (650) 759-0719
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RPH 25524 | Other | CA | CALIFORNIA STATE BOARD OF PHARMACY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH 2524 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378857600000",
"number": "1376978239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 POPPY DR",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940105533",
"telephone_number": "650-759-0719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 POPPY DR",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940105533",
"telephone_number": "650-759-0719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "STANLEY",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-11",
"last_updated": "2013-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH 2524",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA STATE BOARD OF PHARMACY",
"identifier": "RPH 25524",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlingame, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.