Physician Compare National (NPI:1093959108)

HEALTHCARE PROVIDER: VIKRAM UDANI 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	1093959108
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7810153145
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120731000604
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	UDANI
	Individual professional last name
Provider First Name	VIKRAM
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STANFORD UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	NEUROSURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3590 CAMINO DEL RIO N
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 200
	Group Practice or individual's line 2 address
City	SAN DIEGO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	921081707
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050026
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GROSSMONT HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050077
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SCRIPPS MERCY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050324
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SCRIPPS MEMORIAL HOSPITAL LA JOLLA
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	050222
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SHARP CHULA VISTA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	050503
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	SCRIPPS MEMORIAL HOSPITAL - ENCINITAS
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1093959108)

HEALTHCARE PROVIDER: VIKRAM UDANI MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information