Physician Compare National (NPI:1659721850)

HEALTHCARE PROVIDER: SAMVEL KESHISHYAN DPM

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

Individual Professional Information
NPI	1659721850
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6608207592
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200512003232
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KESHISHYAN
	Individual professional last name
Provider First Name	SAMVEL
	Individual professional first name
Provider Middle Name	HOVANY
	Individual professional middle 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	2017
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1339 N COLUMBUS AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	UNIT 311
	Group Practice or individual's line 2 address
City	GLENDALE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	912023875
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y