Physician Compare National (NPI:1841343647)

HEALTHCARE PROVIDER: MERCEDEH MOTAMENI O.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	1841343647
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9638337934
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120220000202
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOTAMENI
	Individual professional last name
Provider First Name	MERCEDEH
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4125 SEPULVEDA BLVD
	Group Practice or individual's line 1 address
City	CULVER CITY
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	902304706
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y