Physician Compare National (NPI:1114160991)

HEALTHCARE PROVIDER: BRANDEN MICHAEL ENGORN 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	1114160991
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789833526
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170922001899
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ENGORN
	Individual professional last name
Provider First Name	BRANDEN
	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	OTHER
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	UNDEFINED PHYSICIAN TYPE (SPECIFY)
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ANESTHESIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ANESTHESIOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	ANESTHESIA SERVICE MEDICAL GROUP
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1153223219
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	236
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3626 RUFFIN RD
	Group Practice or individual's line 1 address
City	SAN DIEGO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	921231810
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6195659666
	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