Physician Compare National (NPI:1689804932)

HEALTHCARE PROVIDER: JOHN S. FRY PH.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	1689804932
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991820797
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100916001233
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FRY
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Middle Name	SCOVELL
	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	1971
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1300 BRISTOL N ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	NEWPORT BEACH
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	926602989
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9498631420
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y