Physician Compare National (NPI:1346387362)

HEALTHCARE PROVIDER: EDUARD BALASANIAN D.D.S., 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	1346387362
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658514161
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20141016001506
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BALASANIAN
	Individual professional last name
Provider First Name	EDUARD
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIV OF CALIF, LOS ANGELES SCHOOL OF DENTISTRY
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	ORAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CUMMINGS BALASANIAN CAPUTO AND NICHOLLS DENTAL GROUP INC
	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	5395639066
	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	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	360 SAN MIGUEL DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 402
	Group Practice or individual's line 2 address
City	NEWPORT BEACH
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	926607830
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9497601600
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y