Physician Compare National (NPI:1174802425)

HEALTHCARE PROVIDER: RICHARD JAMES GRAY O.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	1174802425
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294992665
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180822002257
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRAY
	Individual professional last name
Provider First Name	RICHARD
	Individual professional first name
Provider Middle Name	JAMES
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2011
	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	8381 JUNIPER AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	FONTANA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	923353431
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y