Physician Compare National (NPI:1184977803)

HEALTHCARE PROVIDER: LEWIS KIPLING MOSS 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	1184977803
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294088258
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181205003046
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOSS
	Individual professional last name
Provider First Name	LEWIS KIPLING
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	EMORY UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	DAVID FRIEDBERG MD INC
	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	4486871076
	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	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3628E IMPERIAL HWY 300
	Group Practice or individual's line 1 address
City	LYNWOOD
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	902622646
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3103230624
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050376
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LAC/HARBOR-UCLA MED CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050104
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SAINT FRANCIS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y