Physician Compare National (NPI:1376839167)

HEALTHCARE PROVIDER: KUONG NGANN 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	1376839167
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830321728
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140408000708
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NGANN
	Individual professional last name
Provider First Name	KUONG
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	KND DEVELOPMENT 59 LLC
	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	3678602802
	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	134
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4940 EL CAJON BLVD
	Group Practice or individual's line 1 address
City	SAN DIEGO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	921154637
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6195434500
	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	050248
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NATIVIDAD MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050026
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GROSSMONT HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050038
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SANTA CLARA VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y