NPIMap

Organization Active NPI

Clara Lucy Polak, M.D. Inc.

  • Family Medicine Physician
  • National City, CA
National Provider Identifier
1841342243
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLARA LUCY POLAK, M.D. INC.
Practice address
22 W 35TH St Ste 101
National City, CA 91950-7926
Phone
(619) 427-3361
Fax
(619) 427-6821
NPI assigned
Jan 17, 2007
Last updated
May 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Authorized official

Name
Ms. Kathy Marie Mora
Title
Administrator Assistant
Phone
(619) 427-3361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

22 W 35TH St Ste 101
National City, CA 91950-7926

Mailing address

480 4TH Ave
202
Chula Vista, CA 91910-4410
Phone (619) 427-3361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070514000225 CA Part B Supplier - Clinic/Group Practice 0345347191 Receives reassigned benefits from 14 practitioners
Practice locations: National City, CA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: aafflalo105732@scrippshlth.medalliesdirect.net
  • Direct secure messaging: agutierrez105741@scrippshlth.medalliesdirect.net
  • Direct secure messaging: aryan105734@scrippshlth.medalliesdirect.net
  • Direct secure messaging: cpolak105736@scrippshlth.medalliesdirect.net
  • Direct secure messaging: cstillwell105742@scrippshlth.medalliesdirect.net
  • Direct secure messaging: econcepcion34113@scrippshlth.medalliesdirect.net
  • Direct secure messaging: emejia105733@scrippshlth.medalliesdirect.net
  • Direct secure messaging: galjawadi105739@scrippshlth.medalliesdirect.net
  • Direct secure messaging: lcorsentinomatsumoto105740@scrippshlth.medalliesdirect.net
  • Direct secure messaging: mrabago105743@scrippshlth.medalliesdirect.net
  • Direct secure messaging: mrogers14039@scrippshlth.medalliesdirect.net
  • Direct secure messaging: myelanich105744@scrippshlth.medalliesdirect.net
  • Direct secure messaging: oalb105737@scrippshlth.medalliesdirect.net
  • Direct secure messaging: salb105738@scrippshlth.medalliesdirect.net

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1841342243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 4TH AVE",
            "address_2": "202",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104410",
            "telephone_number": "619-427-3361",
            "fax_number": "619-427-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W 35TH ST STE 101",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919507926",
            "telephone_number": "619-427-3361",
            "fax_number": "619-427-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARA LUCY POLAK, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "MORA",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR ASSISTANT",
        "authorized_official_telephone_number": "619-427-3361",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.