NPIMap

Individual provider Active NPI

Lori Lynn Clark

  • Internal Medicine Physician
  • Laguna Hills, CA
National Provider Identifier
1972634897
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A82608 Issued in CA
Practice address
23521 Paseo de Valencia
Suite 108
Laguna Hills, CA 92653-3107
Phone
(949) 588-7262
Fax
(949) 588-7260
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A82608 CA Primary

Addresses

Primary practice location

23521 Paseo de Valencia
Suite 108
Laguna Hills, CA 92653-3107

Mailing address

23521 Paseo de Valencia
Suite 108
Laguna Hills, CA 92653-3107
Phone (949) 588-7262

Other identifiers 1

IdentifierTypeStateIssuer
A82608OtherMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040817001422 CA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 6709859796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Medical College of Wisconsin, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23521 Pasco de Valencia
Suite 108
Laguna Hills, CA 92653-3137
Phone (949) 588-7262

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Cohen D.O. C.M.D., Inc. Current Accepting new patients
Lori Clark M.D., Inc. Internal Medicine CurrentSince Mar 1, 2006 Accepting new patients
Tommy L. Hicks, M.D., Inc. Current Accepting new patients
Homer Kam Yun Lew,D.O.,a Medical Corporation Internal Medicine Current Accepting new patients
Senior Care Medical Associates, Inc. Internal Medicine Current Accepting new patients
Nermine Morcos, M.D., Inc. Current Accepting new patients
Jorge a. Rivero, M.D., Inc. Current Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Wieler & Sein Medical Group Past Accepting new patients

Locations

23521 Paseo de Valencia
Laguna Hills, CA 92653
Phone (949) 588-7262

23521 Paseo de Valencia
Ste 108
Laguna Hills, CA 92653
Phone (949) 396-1389

655 Camino de los Mares
Ste 122
San Clemente, CA 92673
Phone (949) 588-7262

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lori.clark.1@11277.direct.athenahealth.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1972634897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA",
            "address_2": "SUITE 108",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533107",
            "telephone_number": "949-588-7262",
            "fax_number": "949-588-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA",
            "address_2": "SUITE 108",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533107",
            "telephone_number": "949-588-7262",
            "fax_number": "949-588-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LORI",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A82608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A82608",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.