MATTHEW HARVEY CLARK PA-C NPI 1073520581

NPI Information

NPI: 1073520581
Provider Name: MATTHEW HARVEY CLARK, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
255 N HERWALDT DR
FRESNO, CA
ZIP 93701
Phone: (559) 459-7300
Get Directions

Matthew Harvey Clark, PA-C is a surgical physician assistant in Fresno, CA with 27 years of experience. Matthew Harvey Clark, PA-C NPI is 1073520581. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

255 N HERWALDT DR
FRESNO, CA
ZIP 93701-186
Phone: (559) 459-7300
Fax: (559) 459-3750

The NPI 1073520581 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/1/2006 and was last updated on 7/1/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		PA22496	CALIFORNIA	No
2	363A00000X	Physician Assistant		PA10003694	WASHINGTON	No
3	363AM0700X	Physician Assistant	Medical	PA10003694	WASHINGTON	No
4	363AS0400X	Physician Assistant	Surgical	PA22496	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	Q67314	MEDICARE UPIN
2	8859526	MEDICARE PIN	WASHINGTON
3	8451098	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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