Physician Compare National (NPI:1063592269)

HEALTHCARE PROVIDER: CARLOS ROBERTO MEZA 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	1063592269
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0244220572
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101110000950
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MEZA
	Individual professional last name
Provider First Name	CARLOS
	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	OTHER
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1900 S ATLANTIC BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 3
	Group Practice or individual's line 2 address
City	MONTEREY PARK
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	917546340
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050736
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MONTEREY PARK HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050641
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	EAST LOS ANGELES DOCTORS HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050350
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BEVERLY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y