Individual
DR. SAMUEL J. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1940 EL CAJON BLVD, SAN DIEGO, CA 92104-1005
(619) 543-4500
(619) 295-5600
Mailing address
PO BOX 881609, SAN DIEGO, CA 92168-1609
(619) 794-2521
(619) 794-2523
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A52335
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A52335
CA
207RP1001X
Pulmonary Disease Physician
Primary
A52335
CA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
A52335
CA
Other
Enumeration date
05/31/2006
Last updated
06/25/2024
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