Physician Compare National (NPI:1063517639)

HEALTHCARE PROVIDER: FARAZ OUHADI M.D.

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

Individual Professional Information
NPI	1063517639
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466449855
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040428000260
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	OUHADI
	Individual professional last name
Provider First Name	FARAZ
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	EVERGREEN HEALTH CENTER LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4082958822
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	520 ROUTE 8 106
	Group Practice or individual's line 1 address
City	MAITE
	Group Practice or individual's city
State	GU
	Group Practice or individual's state
Zip Code	96910
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6714805752
	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	650001
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GUAM MEMORIAL HOSPITAL AUTHORITY
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y