Physician Compare National (NPI:1609134352)

HEALTHCARE PROVIDER: REZA KANANI M.D.

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

Individual Professional Information
NPI	1609134352
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7012143373
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180810002882
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KANANI
	Individual professional last name
Provider First Name	REZA
	Individual professional first 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	2006
	Individual professional's medical school graduation year
Primary Specialty	PEDIATRIC MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PACIFIC NEUROMONITORING ASSOCIATES 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	1658433594
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	23822 BITTERN LN
	Group Practice or individual's line 1 address
City	LAGUNA NIGUEL
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	926771344
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8006387564
	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	050481
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WEST HILLS HOSPITAL & MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	380102
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SACRED HEART MEDICAL CENTER - RIVERBEND
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140067
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	OSF SAINT FRANCIS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	140290
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ST ALEXIUS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	230029
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	ST JOSEPH MERCY OAKLAND
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1609134352)

HEALTHCARE PROVIDER: REZA KANANI M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information