DR. PETER CLARK M.D. NPI 1528113628

NPI Information

  • NPI: 1528113628
  • Provider Name: DR. PETER CLARK, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 85 SIERRA PARK RD
    MAMMOTH LAKES, CA
    ZIP 93546
  • Phone: (760) 934-2551

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NPI Details

DR. Peter Clark, M.D. is a family medicine in Mammoth Lakes, CA with 30 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Peter Clark, M.D. NPI is 1528113628. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1996

The provider's business location address is:

85 SIERRA PARK RD
MAMMOTH LAKES, CA
ZIP 93546-660
Phone: (760) 934-2551
Fax: (760) 924-4081

The NPI 1528113628 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 1/25/2007 and was last updated on 3/7/2013.

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
1207Q00000XFamily MedicineA68635CALIFORNIAYes

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: 11/21/2025

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