Physician Compare National (NPI:1295120681)

HEALTHCARE PROVIDER: TIMOTHY CARTER BLOOD JR. 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	1295120681
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1759702830
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200527002190
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BLOOD
	Individual professional last name
Provider First Name	TIMOTHY
	Individual professional first name
Provider Middle Name	CARTER
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
	Individual professional's medical school
Graduation Year	2015
	Individual professional's medical school graduation year
Primary Specialty	OTOLARYNGOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
	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	6406749308
	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	34
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	200 MEDICAL PLAZA
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 550
	Group Practice or individual's line 2 address
City	LOS ANGELES
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	900247002
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3107941110
	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	050262
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RONALD REAGAN U C L A MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y