Physician Compare National (NPI:1063568657)

HEALTHCARE PROVIDER: SOREN N CARLSEN 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	1063568657
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7315093804
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160830001158
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CARLSEN
	Individual professional last name
Provider First Name	SOREN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
	Individual professional's medical school
Graduation Year	2003
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	71 KANOA ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 201
	Group Practice or individual's line 2 address
City	WAILUKU
	Group Practice or individual's city
State	HI
	Group Practice or individual's state
Zip Code	967935816
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8082428765
	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	120002
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MAUI MEMORIAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y