Organization
DAVID A. CLARK, M.D., MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOELENE A GONZALES (BILLING AND CODING SPECIALIST)
(831) 649-9330
Entity
Organization
Contact information
Practice address
880 CASS ST, SUITE 108, MONTEREY, CA 93940-2947
(831) 649-9330
(831) 649-9335
Mailing address
880 CASS ST, SUITE 108, MONTEREY, CA 93940-2947
(831) 649-9330
(831) 649-9335
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00G123030
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G123034
MEDICARE INDIV PTAN
CA
01
—
00G123035
MEDICARE INDIV-STAN PTAN
CA
01
—
060052393
MEDICARE RR
CA
01
—
06E9948
TRICARE
CA
05
—
GR0057973
—
CA
01
—
ZZZ04915Z
MEDICARE GRP-STAN PTAN
CA
01
—
ZZZ39341Z
MEDICARE GRP PTAN
CA
Enumeration date
08/31/2006
Last updated
05/21/2025
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