Physician Compare National (NPI:1316014566)

HEALTHCARE PROVIDER: RODRIGO TOBAR JR. 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	1316014566
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5395861009
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101201000375
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TOBAR
	Individual professional last name
Provider First Name	RODRIGO
	Individual professional first 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	MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	29255 NORTHWESTERN HWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 203
	Group Practice or individual's line 2 address
City	SOUTHFIELD
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	480345741
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230165
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JOHN HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230019
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PROVIDENCE HOSP AND MED CTRS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y