Physician Compare National (NPI:1790971422)

HEALTHCARE PROVIDER: ISAM MAWAS 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	1790971422
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284721788
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170919004322
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MAWAS
	Individual professional last name
Provider First Name	ISAM
	Individual professional first 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	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	9808 VENICE BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 603
	Group Practice or individual's line 2 address
City	CULVER CITY
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	902326819
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050763
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SILVER LAKE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050135
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050742
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	OLYMPIA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	050625
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	CEDARS-SINAI MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	050096
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	WEST COVINA MEDICAL CENTER, INC
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1790971422)

HEALTHCARE PROVIDER: ISAM MAWAS MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information