Physician Compare National (NPI:1194973065)

HEALTHCARE PROVIDER: CLAIRE MICHELE AZZAM 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	1194973065
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9133486566
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171120002562
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AZZAM
	Individual professional last name
Provider First Name	CLAIRE
	Individual professional first name
Provider Middle Name	MICHELE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NEW YORK - STATE COLLEGE OPTOMETRY
	Individual professional's medical school
Graduation Year	2008
	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	828 E MAIN ST
	Group Practice or individual's line 1 address
City	VENTURA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	930012908
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M