Physician Compare National (NPI:1619980521)

HEALTHCARE PROVIDER: ROVENA R REAGAN MD

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

Individual Professional Information
NPI	1619980521
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991891079
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080501000636
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	REAGAN
	Individual professional last name
Provider First Name	ROVENA
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3750 CONVOY ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 311
	Group Practice or individual's line 2 address
City	SAN DIEGO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	921113741
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050100
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SHARP MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050324
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SCRIPPS MEMORIAL HOSPITAL LA JOLLA
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y