Gary Michael Jesus Clark, CHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

8151 Arlington Ave Ste U-V
Riverside, CA 92503-0436

Phone

(951) 688-3001

Fax

(951) 688-3022

NPI assigned

Apr 21, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arlington Physicians Choice a Medical Corporation

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1861796161
  NPD
• San Bernardino Physicians Associates, a Medical Corporation

  • Family Medicine Physician
  • San Bernardino, CA
  • NPI 1487752895
  NPD (past)

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

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1417744863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8151 ARLINGTON AVE STE U-V",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925030436",
            "telephone_number": "951-688-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8151 ARLINGTON AVE STE U-V",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925030436",
            "telephone_number": "951-688-3001",
            "fax_number": "951-688-3022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "407 E Gilbert St Ste 1",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924045325",
            "country_code": "US",
            "telephone_number": "098-889-1136",
            "fax_number": "909-889-2816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13750 Hunters Run Ct",
            "address_purpose": "LOCATION",
            "city": "Eastvale",
            "state": "CA",
            "postal_code": "928805555",
            "country_code": "US",
            "telephone_number": "951-237-1978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GARY",
        "middle_name": "MICHAEL JESUS",
        "credential": "CHW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Milton Clark Jr.
• Brandi Clark
• Chad Leroy Clark, M.D.
• Craig Anson Clark, PA-C
• Danielle Clark
• Isaiah Daniel Clark
• Jaclyn Clark
• Jacorey Clark
• John Patrick Clark
• Kasimira Clark, CCC-SLP

• Community Health Worker in Riverside, CA
• Providers in Riverside, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.