Physician Compare National (NPI:1063589059)

HEALTHCARE PROVIDER: GARY ROBERT DONATH 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	1063589059
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9335219476
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080602000659
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DONATH
	Individual professional last name
Provider First Name	GARY
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TULANE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1551 BISHOP ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 250
	Group Practice or individual's line 2 address
City	SAN LUIS OBISPO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	934014661
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050232
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FRENCH HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050506
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SIERRA VISTA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y