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DR. PAUL RAY CLARK M.D.
NPI 1619362597
Surgery - Plastic and Reconstructive Surgery in San Diego, CA

Active since March 30, 2015PECOS Enrolled
11515 EL CAMINO REAL STE 150, SAN DIEGO, CA 92130(858) 720-1440 Get Directions Write a Review

NPPES record last updated: March 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Paul Ray Clark M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PAUL RAY CLARK M.D. (NPI 1619362597) is an individual plastic and reconstructive surgery provider in San Diego, California, licensed in California (A18267) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619362597
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameDR. PAUL RAY CLARKCredential: M.D.
Location Address11515 EL CAMINO REAL STE 150San Diego, CA 92130-3037
Mailing Address6431 Fannin St, Msb 4.331Houston, TX 77030-1501 · (713) 500-7216
Phone(858) 720-1440
Sole ProprietorNo
Enumeration DateMarch 30, 2015
Last NPPES UpdateMarch 5, 2024
NPPES CertifiedMarch 5, 2024
✔ NPI 1619362597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in CA · A18267
Definition
A surgeon who specializes in plastic and reconstructive surgery.
11515 EL CAMINO REAL STE 150, San Diego, CA 92130
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Paul Ray Clark M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CALIFORNIA INSTITUTE OF PLASTIC AND RECONSTRUCTIVE SURGERY A MED. CORP
Clinic/Center (Medical Specialty)
11515 EL CAMINO REAL STE 150
SAN DIEGO, CA 92130
San Diego County (858) 720-1440

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Clark's NPI number?

The NPI number for Paul Clark is 1619362597. It was assigned to this individual provider in the NPPES registry on March 30, 2015.

Where is Paul Clark located?

Paul Clark practices at 11515 El Camino Real Ste 150, San Diego, CA 92130. The listed phone number is (858) 720-1440.

What is Paul Clark's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Paul Clark enrolled in Medicare?

Yes. Paul Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Paul Clark was last updated on March 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.