Physician Compare National (NPI:1407952229)

HEALTHCARE PROVIDER: DR. AYYAMPALAYAM RAJU MOHAN

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1407952229
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224173927
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110829000197
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOHAN
	Individual professional last name
Provider First Name	AYYAMPALAYAM
	Individual professional first name
Provider Middle Name	RAJU
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	VASCULAR SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	VASCULAR SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1818 N ORANGE GROVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 308
	Group Practice or individual's line 2 address
City	POMONA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	917673028
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050231
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	POMONA VALLEY HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y