Physician Compare National (NPI:1881655744)

HEALTHCARE PROVIDER: SAM FILICIOTTO 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	1881655744
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2062594203
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080128000406
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FILICIOTTO
	Individual professional last name
Provider First Name	SAM
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1982
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	15708 POMERADO RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 207N
	Group Practice or individual's line 2 address
City	POWAY
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	920642036
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050636
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	POMERADO HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050115
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PALOMAR HEALTH DOWNTOWN CAMPUS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	M