Physician Compare National (NPI:1023020252)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1023020252
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3577698950
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100419000280
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COHEN
	Individual professional last name
Provider First Name	DAVID
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1960
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	909 HYDE ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 505
	Group Practice or individual's line 2 address
City	SAN FRANCISCO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	941094853
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4154416669
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050152
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT FRANCIS MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y