Lori J Clark, O.D. Inc, an Optometric Corporation

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

Legal business name

LORI J CLARK, O.D. INC, AN OPTOMETRIC CORPORATION

Practice address

1145 Manhattan Ave
Manhattan Beach, CA 90266-5333

Phone

(310) 546-4618

Fax

(310) 546-9268

NPI assigned

Mar 5, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Lori J Clark, ODNPI 1073575213

Title

Owner

Phone

(310) 546-4618

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lori J Clark, O.D.

  • Optometrist
  • Manhattan Beach, CA
  • NPI 1073575213
  NPD (past) Authorized official

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551744000000",
    "number": "1952869257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 MANHATTAN AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665333",
            "telephone_number": "310-546-4618",
            "fax_number": "310-546-9268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 MANHATTAN AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665333",
            "telephone_number": "310-546-4618",
            "fax_number": "310-546-9268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORI J CLARK, O.D. INC, AN OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-03-05",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-546-4618",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0089501",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stewart Lovelace, M.D.
• Angelie Vanessa Loza, NP
• Barbara Carol Lucas, MD
• Lizette Ludwig, FNP

• Corneal and Contact Management Optometrist in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Corneal and Contact Management Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.