Craig Anson Clark, PA-C

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

10026 Issued in CA

Practice address

3579 Arlington Ave Ste 300
Riverside, CA 92506-3915

Phone

(951) 341-9333

Fax

(951) 341-9330

NPI assigned

Jan 5, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1952015802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 GRINNELL DR",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "925097046",
            "telephone_number": "951-733-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3579 ARLINGTON AVE STE 300",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063915",
            "telephone_number": "951-341-9333",
            "fax_number": "951-341-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CRAIG",
        "middle_name": "ANSON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "10026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "10026",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.ieomworkinjuries.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3579 Arlington Ave Ste 300",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925063915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Yvette Clark Rhoe, MSW
• Alexis Nicole Clark, NP
• Arthur Milton Clark Jr.
• Brandi Clark
• Chad Leroy Clark, M.D.
• Danielle Clark
• Gary Michael Jesus Clark, CHW
• Isaiah Daniel Clark
• Jaclyn Clark
• Jacorey Clark

• Occupational Medicine Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Occupational Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.