Physician Compare National (NPI:1386674000)

HEALTHCARE PROVIDER: THEODORE AFFUE 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	1386674000
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6204724099
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040304000786
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AFFUE
	Individual professional last name
Provider First Name	THEODORE
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2061 ROSS AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	EL CENTRO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	922433687
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050045
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	EL CENTRO REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	030013
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	YUMA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050342
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	PIONEERS MEMORIAL HEALTHCARE DISTRICT
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y