Physician Compare National (NPI:1770545568)

HEALTHCARE PROVIDER: NINA ELLEN KOTTLER MD

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

Individual Professional Information
NPI	1770545568
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022043736
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120612000673
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KOTTLER
	Individual professional last name
Provider First Name	NINA
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	2000
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	COASTAL RADIOLOGY ASSOCIATES, PLLC
	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	8224002696
	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	64
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	18278 VIA DE SUENO
	Group Practice or individual's line 1 address
City	RANCHO SANTA FE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	92067
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2526338711
	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