Thomas J Clark DO Inc

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

20A8621 Issued in CA

Legal business name

THOMAS J CLARK DO INC

Practice address

620 California Blvd.
Suite J
San Luis Obispo, CA 93401-2598

Phone

(805) 547-2275

Fax

(805) 547-2279

NPI assigned

Jan 4, 2007

Last updated

Mar 5, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Joseph Clark, D.O.

Title

President

Phone

(805) 547-2275

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236211200000",
    "number": "1669529582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 CALIFORNIA BLVD.",
            "address_2": "SUITE J",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012598",
            "telephone_number": "805-547-2275",
            "fax_number": "805-547-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 CALIFORNIA BLVD.",
            "address_2": "SUITE J",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012598",
            "telephone_number": "805-547-2275",
            "fax_number": "805-547-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J CLARK DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2009-03-05",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-547-2275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "20A8621",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "20A8621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; 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.