Active NPI
Eric Norberg Clark, M.D.
- Specialist
- Irvine, CA
National Provider Identifier
1932284478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- G77089
- Practice address
- 6 Willard
Irvine, CA 92604-4694 - Phone
- (888) 988-2800
- Fax
- (626) 405-6768
- NPI assigned
- Oct 25, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | G77089 | CA | Primary |
Addresses
Primary practice location
6 Willard
Irvine, CA 92604-4694
Mailing address
6 Willard
Irvine, CA 92604-4694
Phone (888) 988-2800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G77089 | Other | CA | STATE LICENSE # |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G77089 | CA | MD | Specialist |
| 77089 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479427200000",
"number": "1932284478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 WILLARD",
"city": "IRVINE",
"state": "CA",
"postal_code": "926044694",
"telephone_number": "888-988-2800",
"fax_number": "626-405-6768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 WILLARD",
"city": "IRVINE",
"state": "CA",
"postal_code": "926044694",
"telephone_number": "888-988-2800",
"fax_number": "626-405-6768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ERIC",
"middle_name": "NORBERG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2016-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "G77089",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE #",
"identifier": "G77089",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.