Physician Compare National (NPI:1003042342)

HEALTHCARE PROVIDER: MOSTAFA TABASSOMI MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1003042342
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2365582913
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091214000067
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TABASSOMI
	Individual professional last name
Provider First Name	MOSTAFA
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	PULMONARY DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CRITICAL CARE (INTENSIVISTS)
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	INTERNAL MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CRITICAL CARE (INTENSIVISTS), INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	23838 VALENCIA BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 304
	Group Practice or individual's line 2 address
City	VALENCIA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	913555319
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050624
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HENRY MAYO NEWHALL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050278
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PROVIDENCE HOLY CROSS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y