Physician Compare National (NPI:1558411579)

HEALTHCARE PROVIDER: SUZANNE LYNN GOODMAN OPTOMETRIST

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

Individual Professional Information
NPI	1558411579
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4587802301
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130605000765
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GOODMAN
	Individual professional last name
Provider First Name	SUZANNE
	Individual professional first name
Provider Middle Name	LYNN
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	5722 TELEPHONE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	C6
	Group Practice or individual's line 2 address
City	VENTURA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	930035318
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y