NPIMap

Organization Active NPI

Julie Clark, M.D., Inc

  • Obstetrics & Gynecology Physician
  • Petaluma, CA
National Provider Identifier
1528211638
Registry record updated Nov 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A98041 Issued in CA
Legal business name
JULIE CLARK, M.D., INC
Practice address
1550 Professional Dr
Petaluma, CA 94954-6655
Phone
(707) 792-2229
Fax
(707) 729-1072
NPI assigned
Nov 3, 2008
Last updated
Nov 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2008

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

Authorized official

Name
Linda M Jones
Title
Insurance Biller
Phone
(707) 823-4695

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A98041 CA Primary

Addresses

Primary practice location

1550 Professional Dr
Petaluma, CA 94954-6655

Mailing address

1550 Professional Dr
Petaluma, CA 94954-6655
Phone (707) 792-2229

National Provider Directory

National Provider Directory

Locations

1550 Professional Dr
Petaluma, CA 94954
Phone (707) 792-2229

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227312000000",
    "number": "1528211638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 PROFESSIONAL DR",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546655",
            "telephone_number": "707-792-2229",
            "fax_number": "707-729-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 PROFESSIONAL DR",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546655",
            "telephone_number": "707-792-2229",
            "fax_number": "707-729-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE CLARK, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INSURANCE BILLER",
        "authorized_official_telephone_number": "707-823-4695"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A98041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2008; 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.