Physician Compare National (NPI:1699700377)

HEALTHCARE PROVIDER: TADD LEIGH SELBY 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	1699700377
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3678617719
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100212000525
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SELBY
	Individual professional last name
Provider First Name	TADD
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1166 ESPLANADE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 3
	Group Practice or individual's line 2 address
City	CHICO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	959263361
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050039
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ENLOE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050030
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	OROVILLE HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	051317
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ADVENTIST HEALTH CLEARLAKE
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	050133
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	RIDEOUT MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	051306
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	GLENN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1699700377)

HEALTHCARE PROVIDER: TADD LEIGH SELBY M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information