Physician Compare National (NPI:1104887629)

HEALTHCARE PROVIDER: KAREN S COLLOM OD

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

Individual Professional Information
NPI	1104887629
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901076934
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120105000324
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COLLOM
	Individual professional last name
Provider First Name	KAREN
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CALIFORNIA - SCHOOL OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3162 CAMPUS DR
	Group Practice or individual's line 1 address
City	SAN MATEO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	944033123
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6503450248
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y