Active NPI
Don L Clarke, M.D.
- Dermatology Physician
- Mission Hills, CA
National Provider Identifier
1477557395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- C39677
- Practice address
- 14901 Rinaldi St
Ste 201
Mission Hills, CA 91345-1254 - Phone
- (818) 838-6716
- Fax
- (818) 838-9279
- NPI assigned
- Jun 9, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | C39677 | CA | Primary |
Addresses
Primary practice location
14901 Rinaldi St
Ste 201
Mission Hills, CA 91345-1254
Mailing address
777 Flower St
Ste a
Glendale, CA 91201-3000
Phone (818) 637-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C396770 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Medical Organization, a Medical Group Inc. | Dermatology | Past | Accepting new patients |
| Mahfouz M. Michael,M.D.,Inc. | Past | Accepting new patients | |
| Lakeside Medical Associates, a Medical Group, Inc. | Dermatology | Past | Accepting new patients |
| Mahfouz M. Michael,M.D.,Inc. | Past | Accepting new patients |
Organizations & group practices 4
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.
-
dba Lakeside Community Healthcare Medical Group
- Hospitalist Physician
- Glendale, CA
- NPI 1932129434
Dermatology
-
- Internal Medicine Physician
- West Hills, CA
- NPI 1831426642
Dermatology
-
dba Clinica Medica San Miguel
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1093934986
-
dba Clinica Medica San Miguel
- Internal Medicine Physician
- San Fernando, CA
- NPI 1609095587
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189641600000",
"number": "1477557395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 FLOWER ST",
"address_2": "STE A",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912013000",
"telephone_number": "818-637-2000",
"fax_number": "818-242-8761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14901 RINALDI ST",
"address_2": "STE 201",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "913451254",
"telephone_number": "818-838-6716",
"fax_number": "818-838-9279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "DON",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-09",
"last_updated": "2007-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "C39677",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C396770",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mission Hills, CA
- Ngozi Chukwuemeka
- Christopher Chung
- Cinthya Elizabeth Cisneros, PTA
- City of Hope Medical Foundation (City of Hope Mission Hills)
- Joel David Clarfield, M.D.
- Melvin Noe Claros, RT
- Delora Ann Marie Climaco, MD.
- Comfort Aid Hospice Care Corporation
- Comforting Care Home Health Services, Inc.
- Community Dental Services (SmileCare Dental Group)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.