Physician Compare National (NPI:1790784692)

HEALTHCARE PROVIDER: MAN TAI LAM 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	1790784692
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0446163919
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20041117000855
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LAM
	Individual professional last name
Provider First Name	MAN
	Individual professional first name
Provider Middle Name	TAI
	Individual professional middle name
Provider Gender	M
	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	OTHER
	Individual professional's medical school
Graduation Year	1973
	Individual professional's medical school graduation year
Primary Specialty	INFECTIOUS DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1221 N COTTON
	Group Practice or individual's line 1 address
Line 2 Street Address	FIRST FLOOR
	Group Practice or individual's line 2 address
City	EL PASO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	799023015
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9155981600
	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	450107
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LAS PALMAS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450002
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y