Physician Compare National (NPI:1730441114)

HEALTHCARE PROVIDER: ROSE CHEPKOECH CHUMO 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	1730441114
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8325288178
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20151103001195
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHUMO
	Individual professional last name
Provider First Name	ROSE
	Individual professional first name
Provider Middle Name	CHEPKOECH
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2008
	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
Organization Legal Name	PERMANENTE MEDICAL GROUP INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8921910225
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	5849
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1600 EUREKA RD
	Group Practice or individual's line 1 address
City	ROSEVILLE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	956613027
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9167844000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050309
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SUTTER ROSEVILLE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050498
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SUTTER AUBURN FAITH HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050108
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SUTTER MEDICAL CENTER, SACRAMENTO
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y