Gary C. Clark, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G50138 Issued in CA

Practice address

7901 Frost St
Sharp Memorial Hospital
San Diego, CA 92123-2701

Phone

(858) 939-3525

NPI assigned

Oct 25, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1518042274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2956 MCGRAW ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176045",
            "telephone_number": "510-610-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 FROST ST",
            "address_2": "SHARP MEMORIAL HOSPITAL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232701",
            "telephone_number": "858-939-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GARY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G50138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G501380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David A. Clark, M.D.
• Delbert David Clark, D.O.
• Donia Clark, MD
• Dory Clark, NP
• Eric Leonard Clark, M.D.
• Hunter Clark
• Jacqueline Clark, M.A.
• Jamesha Clark
• Janet Loraine Clark, LMFT
• Jillian Clark, PHD

• Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.