Physician Compare National (NPI:1477944114)

HEALTHCARE PROVIDER: FARID DIDARI

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

Individual Professional Information
NPI	1477944114
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4981907920
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160125001965
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DIDARI
	Individual professional last name
Provider First Name	FARID
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	EMPIRE FOOT AND ANKLE CENTER INC.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1254617244
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1141 W REDONDO BEACH BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 302
	Group Practice or individual's line 2 address
City	GARDENA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	902473583
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3105158155
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050758
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MONTCLAIR HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050782
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CASA COLINA HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y