Physician Compare National (NPI:1396060794)

HEALTHCARE PROVIDER: ANGIE KORIAKOS 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	1396060794
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658683263
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150709001936
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KORIAKOS
	Individual professional last name
Provider First Name	ANGIE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	COLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
	Individual professional's medical school
Graduation Year	2010
	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	399 W CAMPBELL RDSTE
	Group Practice or individual's line 1 address
Line 2 Street Address	410 METHODIST RICHARDSON MEDICAL BLDG 2
	Group Practice or individual's line 2 address
City	RICHARDSON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	750803636
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y