Physician Compare National (NPI:1861683245)

HEALTHCARE PROVIDER: EDWARD KAZUHISA NOMOTO 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	1861683245
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840469276
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110801000747
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NOMOTO
	Individual professional last name
Provider First Name	EDWARD
	Individual professional first name
Provider Middle Name	K
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STANFORD UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	444 S SAN VICENTE BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 800
	Group Practice or individual's line 2 address
City	LOS ANGELES
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	900484174
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3104239780
	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	050625
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CEDARS-SINAI MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050290
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PROVIDENCE SAINT JOHN'S HEALTH CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050785
	Medicare CCN of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y