Physician Compare National (NPI:1871625194)

HEALTHCARE PROVIDER: THOMAS EARL HAVEL M.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	1871625194
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668639154
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120213000029
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAVEL
	Individual professional last name
Provider First Name	THOMAS
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC PSYCHIATRY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC PSYCHIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2500 GRANT RD
	Group Practice or individual's line 1 address
City	MOUNTAIN VIEW
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	940404302
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6503610646
	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	050308
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	EL CAMINO HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M