Physician Compare National (NPI:1669655817)

HEALTHCARE PROVIDER: SAURABH BASU KANDPAL 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	1669655817
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4789758723
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190711003116
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KANDPAL
	Individual professional last name
Provider First Name	SAURABH
	Individual professional first name
Provider Middle Name	BASU
	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	2003
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	10470 VISTA DEL SOL DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 105
	Group Practice or individual's line 2 address
City	EL PASO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	799257928
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450107
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LAS PALMAS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	670120
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450002
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	450877
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	FOUNDATION SURGICAL HOSPITAL OF EL PASO
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	450668
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	THE HOSPITALS OF PROVIDENCE - SIERRA CAMPUS
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1669655817)

HEALTHCARE PROVIDER: SAURABH BASU KANDPAL M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information