Physician Compare National (NPI:1417932047)

HEALTHCARE PROVIDER: SANDRA LIZBETH PARKER DDS

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

Individual Professional Information
NPI	1417932047
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618218108
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190410001777
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PARKER
	Individual professional last name
Provider First Name	SANDRA
	Individual professional first name
Provider Middle Name	LIZBETH
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	ORAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	843 S STATE COLLEGE BLVD
	Group Practice or individual's line 1 address
City	ANAHEIM
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	928064613
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y