Physician Compare National (NPI:1235455262)

HEALTHCARE PROVIDER: ALEX P PALLAS DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1235455262
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991014169
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170525001359
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PALLAS
	Individual professional last name
Provider First Name	ALEX
	Individual professional first 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	2010
	Individual professional's medical school graduation year
Primary Specialty	INTERVENTIONAL RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	DIAGNOSTIC RADIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	DIAGNOSTIC RADIOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	LAKES REGION RADIOLOGY PA
	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	4789673419
	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	14
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	227 EASY ST
	Group Practice or individual's line 1 address
Line 2 Street Address	APT C
	Group Practice or individual's line 2 address
City	MOUNTAIN VIEW
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	940433744
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6035242534
	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	050039
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ENLOE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050516
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MERCY SAN JUAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050017
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MERCY GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	050127
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	WOODLAND MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	050414
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	MERCY HOSPITAL OF FOLSOM
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1235455262)

HEALTHCARE PROVIDER: ALEX P PALLAS DO

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information