Active NPI
John-Stephen Rosell Clark, PHARM.D.
- Pharmacist
- Camp Pendleton, CA
National Provider Identifier
1750659959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 65589
- Practice address
- 200 Mercy Circle
Camp Pendleton, CA 92055 - Phone
- (607) 719-3578
- NPI assigned
- Dec 2, 2011
- Last updated
- Jan 31, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.294812 | IL | |
| Pharmacist | 183500000X | 65589 | CA | Primary |
Addresses
Primary practice location
200 Mercy Circle
Camp Pendleton, CA 92055
Mailing address
200 Mercy Circle
Camp Pendleton, CA 92055
Phone (760) 719-3578
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65589 | CA | MD | Pharmacist |
| 051.294812 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738281600000",
"number": "1750659959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MERCY CIRCLE",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "92055",
"telephone_number": "760-719-3578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MERCY CIRCLE",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "92055",
"telephone_number": "607-719-3578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JOHN-STEPHEN",
"middle_name": "ROSELL",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-02",
"last_updated": "2025-01-31",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.294812",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "65589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Pendleton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.