Ellen Margaret Clark, DO in Oakland, CA

Ellen Margaret Clark, DO is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Oakland, California. Her current practice location is 3600 Broadway Lowr Level, Oakland, California. You can reach out to her office (for appointments etc.) via phone at (510) 752-5991.

Ellen Margaret Clark is licensed to practice in California (license number 20A23964) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1174083596.

Contact Information

	Ellen Margaret Clark, DO
	3600 Broadway Lowr Level, Oakland, CA 94611-5730
	(510) 752-5991
	Not Available

Map and Direction

Physician's Profile

Full Name	Ellen Margaret Clark
Gender	Female
Speciality	Radiology - Diagnostic Radiology
Location	3600 Broadway Lowr Level, Oakland, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174083596
Provider Enumeration Date: 03/21/2019
Last Update Date: 08/04/2025

Medicare PECOS Information:

PECOS PAC ID: 8820326028
Enrollment ID: I20190827000365

Medical Identifiers

Medical identifiers for Ellen Margaret Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174083596	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085P0229X	Radiology - Pediatric Radiology	20A23964 (California)	Secondary
2085R0202X	Radiology - Diagnostic Radiology	20A23964 (California)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ellen Margaret Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ellen Margaret Clark, DO 3600 Broadway Lowr Level, Oakland, CA 94611-5730 Ph: () -	Ellen Margaret Clark, DO 3600 Broadway Lowr Level, Oakland, CA 94611-5730 Ph: (510) 752-5991

Reviews and Comments

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Ellen Margaret Clark, DO - Medicare Radiology in Oakland, CA