Clark E. Smith, M.D. a Medical Corporation

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G49105 Issued in CA

Legal business name

CLARK E. SMITH, M.D. A MEDICAL CORPORATION

Practice address

9820 Willow Creek Rd
Suite 370
San Diego, CA 92131

Phone

(858) 530-9112

Fax

(858) 530-9118

NPI assigned

May 1, 2009

Organization subpart

No

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

Authorized official

Name

Clark E. Smith, M.D.

Title

Owner

Phone

(858) 530-9112

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242950400000",
    "number": "1942444120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9820 WILLOW CREEK RD",
            "address_2": "SUITE 370",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92131",
            "telephone_number": "858-530-9112",
            "fax_number": "858-530-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9820 WILLOW CREEK RD",
            "address_2": "SUITE 370",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92131",
            "telephone_number": "858-530-9112",
            "fax_number": "858-530-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK E. SMITH, M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2009-05-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-530-9112",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G49105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G491050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark F Clapper, MD
• Michael J. Clar, MD
• Erin Paige Clarelli, OTR/L
• Jim Mario Clarin, PMH-BC
• Kristen Clark Boyar, BCBA
• Stephanie Clark-Bubion
• Abigail Clark
• Aimee Le Zakrewski Clark, MFT
• Alan E Clark, ALAN CLARK
• Alana Sandra Clark

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.