Physician Compare National (NPI:1326100835)

HEALTHCARE PROVIDER: KATHY MARIE CLEWELL 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	1326100835
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557430329
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080520000231
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CLEWELL
	Individual professional last name
Provider First Name	KATHY
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	15525 POMERADO RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A4
	Group Practice or individual's line 2 address
City	POWAY
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	920642425
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8585927040
	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	050636
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	POMERADO HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y