Clark Izu, DDS in Irvine, CA - Medicare Dentist Provider

Clark Izu, DDS is a medicare enrolled "Dentist - Endodontics" provider in Irvine, California. His current practice location is 20 Maryland, Irvine, California. You can reach out to his office (for appointments etc.) via phone at (562) 544-7033.

Clark Izu is licensed to practice in California (license number 42920) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1114283033.

Contact Information

	Clark Izu, DDS
	20 Maryland, Irvine, CA 92606-1739
	(562) 544-7033
	Not Available

Healthcare Provider's Profile

Full Name	Clark Izu
Gender	Male
Speciality	Dentist - Endodontics
Location	20 Maryland, Irvine, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114283033
Provider Enumeration Date: 04/04/2012
Last Update Date: 04/04/2012

Medicare PECOS Information:

PECOS PAC ID: 1759696115
Enrollment ID: I20150813010551

Medical Identifiers

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

Identifier	Type	State	Issuer
1114283033	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223E0200X	Dentist - Endodontics	42920 (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. Clark Izu 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
Clark Izu, DDS 20 Maryland, Irvine, CA 92606-1739 Ph: (562) 544-7033	Clark Izu, DDS 20 Maryland, Irvine, CA 92606-1739 Ph: (562) 544-7033

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Clark Izu, DDS - Medicare Dentist in Irvine, CA