Physician Compare National (NPI:1205050655)

HEALTHCARE PROVIDER: S ISMAIL AH BOKHARI SR. 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	1205050655
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567497746
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100702000090
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOKHARI
	Individual professional last name
Provider First Name	ISMAIL
	Individual professional first name
Provider Middle Name	A H
	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	1970
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3269 STOCKTON HILL RD
	Group Practice or individual's line 1 address
City	KINGMAN
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	864013619
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	030055
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	KINGMAN REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	030002
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BANNER - UNIVERSITY MEDICAL CENTER PHOENIX
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y