Physician Compare National (NPI:1386702090)

HEALTHCARE PROVIDER: LISA WOOLF 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	1386702090
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183781172
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090318000360
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WOOLF
	Individual professional last name
Provider First Name	LISA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	DERMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	32144 AGOURA RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 202
	Group Practice or individual's line 2 address
City	WESTLAKE VILLAGE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	913614048
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050107
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MARIAN REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y