Dennis L Clark, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G25400 Issued in CA

Practice address

3816 Woodruff Ave
Suite 401
Long Beach, CA 90808-2147

Phone

(562) 420-8679

NPI assigned

Jul 12, 2006

Last updated

Sep 7, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Partners, a Medical GroupGroup PAC ID 2769388412, 236 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Divine Pearl Home Health Home health agency, Anaheim, CA, CCN 757422

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

• Prohealth Partners, a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1003949975
  Medicare reassignment Care Compare group NPD
• Careconnectmd Ca PC

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1366063125
  Medicare reassignment NPD
• Prohealth Partners a Medical Group Inc

  • Internal Medicine Physician
  • Long Beach, CA
  • NPI 1942332937
  NPD
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Pico Rivera, CA
  • NPI 1912899394
  NPD
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)
• Long Beach Memorial Medical

  dba Miller Children's Hospital

  • Children's Hospital
  • Long Beach, CA
  • NPI 1477596583
  NPD (past)
• Los Alamitos Medical Center, Inc.

  dba Los Alamitos Medical Center

  • Psychiatric Hospital Unit
  • Los Alamitos, CA
  • NPI 1497780084
  NPD (past)
• St Francis Medical Center

  • Long Term Care Hospital
  • Lynwood, CA
  • NPI 1346378270
  NPD (past)
• Tri-City Hospital

  dba Tri-City Medical Center

  • General Acute Care Hospital
  • Oceanside, CA
  • NPI 1801861190
  NPD (past)
• University of California Irvine

  dba UCI Health Lakewood

  • General Acute Care Hospital
  • Lakewood, CA
  • NPI 1184655581
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Divine Pearl Home Health

  • Home Health Agency
  • Anaheim, CA
  • NPI 1154996676
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1699700849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 WOODRUFF AVE",
            "address_2": "SUITE 401",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 WOODRUFF AVE",
            "address_2": "SUITE 401",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082147",
            "telephone_number": "562-420-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DENNIS",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G25400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark White Licensed Clinical Social Worker Inc (Brighten Every Life Counseling Services)
• Amber Shiori Clark
• April Calista Clark
• Carolyn Bentley Clark, RN
• Charles Curtis Clark, M.D.
• Diana Marcela Clark, M.S., SLP
• Elyse Marteal Clark
• Gloria Dehaven Clark, CADCA
• Helen Jean Clark
• Jerald Lamont Clark

• Internal Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.