Physician Compare National (NPI:1770796336)

HEALTHCARE PROVIDER: BENJAMIN QUIAMBAO 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	1770796336
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6709912413
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100406000414
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	QUIAMBAO
	Individual professional last name
Provider First Name	BENJAMIN
	Individual professional first name
Provider Middle Name	Y
	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	2000
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2227 W LINDSEY ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1550
	Group Practice or individual's line 2 address
City	NORMAN
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	730694075
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050292
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RIVERSIDE UNIVERSITY HEALTH SYSTEM-MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M